Individual
MS. KRYSTAL K BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
157 SIGNAL HILL DR, SAINT LOUIS, MO 63121-1219
(314) 629-9896
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2016037826
MO
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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