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Individual

LAKYNN R BRADSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1307 PORTER WAGONER BLVD, WEST PLAINS, MO 65775-1828
(417) 255-8645
Mailing address
1128 MOUNT CALM RD, VIOLA, AR 72583-9445
(870) 371-0380

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2022031561
MO
363LF0000X
Family Nurse Practitioner
Primary
220776
AR

Other

Enumeration date
06/17/2022
Last updated
02/13/2024
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