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Individual

THERESA BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
411 BISHOP CT, MOREHEAD, KY 40351-1009
(606) 784-2096
(606) 784-5886
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1073566
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000345158
ANTHEM BCBS
01
2701192
UNITED HEALTHCARE
05
30610026
KY
Enumeration date
10/10/2006
Last updated
02/12/2025
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