Individual
MS. CONSTANCE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1415 COLLEGE DR, MERIDIAN, MS 39307-5345
(601) 483-4821
Mailing address
1415 COLLEGE DR, MERIDIAN, MS 39307-5345
(601) 483-4821
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
902831
MS
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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