Individual
MS. MARGIE DIANNE BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
823 JEFF GOODWIN ST, BRANDON, MS 39042-8763
(601) 825-7945
(601) 825-7945
Mailing address
823 JEFF GOODWIN ST, BRANDON, MS 39042-8763
(601) 825-7945
(601) 825-7945
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P260448
MS
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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