Individual
SHANNA JOY BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-3000
Mailing address
4609 BLAISDELL AVE APT 3, MINNEAPOLIS, MN 55419-5548
(952) 239-5040
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R 153301-3
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
100356
MN
Other
Enumeration date
11/04/2013
Last updated
12/13/2013
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