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Individual

CATHY A BRADLEY

Active
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Individual

CATHY A BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
R039083
ME
364S00000X
Clinical Nurse Specialist
Primary
CNP81391
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100064
ANTHEM ID#
ME
05
—
252580099
—
ME
01
—
3670340
AETNA ID
ME
Enumeration date
08/13/2006
Last updated
02/14/2020
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