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Individual

SHANNON LESLIE BRADBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP-BC

Contact information

Practice address
2050 N HAGGERTY RD STE 140, CANTON, MI 48187-3796
(734) 595-1166
Mailing address
11357 MCGREGOR RD, PINCKNEY, MI 48169-9526
(734) 262-4520

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
4704340785
MI
363LF0000X
Family Nurse Practitioner
Primary
4704340785NSA220XB
MI

Other

Enumeration date
01/11/2022
Last updated
07/07/2023
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