Individual
SAMANTHA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
664 SLATE AVE, OWINGSVILLE, KY 40360-2206
(866) 233-1955
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1176342
KY
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
1176342
KY
Other
Enumeration date
03/03/2022
Last updated
02/27/2025
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