Individual
JENNIFER BLASE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13430 N MERIDIAN ST, SUITE 275, CARMEL, IN 46032-1405
(317) 582-8810
(317) 582-8863
Mailing address
13430 N MERIDIAN ST, SUITE 275, CARMEL, IN 46032-1405
(317) 582-8810
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085-002534
IL
363AS0400X
Surgical Physician Assistant
Primary
10001216A
IN
Other
Enumeration date
10/10/2006
Last updated
06/01/2022
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