Individual
MR. NATHAN ERIC BRADFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2280 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 227-2100
(208) 227-2362
Mailing address
PO BOX 742358, ATLANTA, GA 30374-2358
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-1317A
ID
Other
Enumeration date
08/19/2013
Last updated
03/13/2023
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