Individual
JENNIFER BRADLEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 369-4777
(319) 369-4694
Mailing address
PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
(319) 369-4505
(319) 369-4677
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G095464
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442376
—
IA
Enumeration date
03/30/2006
Last updated
07/08/2007
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