Individual
CATHY A BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
521 MAIN STREET, PRESQUE ISLE, ME 04769
(207) 764-9700
(207) 764-9703
Mailing address
521 MAIN STREET, PRESQUE ISLE, ME 04769
(207) 764-9700
(207) 764-9703
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
R039083
ME
364S00000X
Clinical Nurse Specialist
Primary
CNP81391
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100064
ANTHEM ID#
ME
05
—
252580099
—
ME
01
—
3670340
AETNA ID
ME
Enumeration date
08/13/2006
Last updated
02/14/2020
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