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Individual

TERRI LYNN BRADDOCK-HARTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, BC

Contact information

Practice address
201 BAILEY LN, BENTON, IL 62812-1969
(618) 439-3161
(618) 435-2969
Mailing address
309 W SAINT LOUIS ST, STE C, WEST FRANKFORT, IL 62896-2047
(618) 899-3636
(618) 241-4863

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209003437
IL
363LF0000X
Family Nurse Practitioner
209-003437
IL

Other

Enumeration date
10/25/2006
Last updated
03/30/2023
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