# CSD MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538309489
- **Authorized official:** SHELLEY D. BRADLEY ARNP, RNFA (OWNER, PROVIDER)
- **Authorized official phone:** (859) 227-4835

## Contact information

- **Practice address:** 18 VILLAGE PLZ, SHELBYVILLE, KY 40065-1745
- **Practice address phone:** (859) 227-4835
- **Practice address fax:** (502) 453-0790
- **Mailing address:** 18 VILLAGE PLZ, SHELBYVILLE, KY 40065-1745
- **Mailing address phone:** (859) 227-4835
- **Mailing address fax:** (502) 453-0790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4229P | KY | Yes |

## Other

- **Enumeration date:** 03/04/2009
- **Last updated:** 03/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000562862 | ANTHEM BCBS | KY |
| 05 | — | 78014354 | — | KY |