Individual
MRS. BEVERLY ANN BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
2521 BEECHWOOD DR, ELIZABETHTON, TN 37643-5062
(423) 543-7919
(423) 543-5323
Mailing address
2521 BEECHWOOD DR, ELIZABETHTON, TN 37643-5062
(423) 543-7919
(423) 543-5323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
49977
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043282502
NPI NUMBER
TN
01
—
3348271
MEDICARE PTAN
TN
01
—
3348272
MECICARE PTAN
TN
01
—
3348273
MEDICARE PTAN
TN
Enumeration date
02/07/2006
Last updated
04/11/2012
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