Individual
KRISTINA KAY BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
Mailing address
811 E GORDON AVE, EFFINGHAM, IL 62401-3724
(217) 821-5696
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209010611
IL
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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