Individual
BRADLEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
5408 W BURLEIGH ST, MILWAUKEE, WI 53210-1624
(414) 362-8147
Mailing address
285 N JANACEK RD, BROOKFIELD, WI 53045-6102
(262) 641-9050
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5437-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5437
WI
Other
Enumeration date
08/30/2013
Last updated
08/01/2019
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