Individual
TIFFANI L BRADBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
300 UTAH ST, HIAWATHA, KS 66434-2326
(785) 742-2131
(785) 742-6558
Mailing address
300 UTAH ST, HIAWATHA, KS 66434-2326
(785) 742-2131
(785) 742-6558
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018022116
MO
363LF0000X
Family Nurse Practitioner
53-82316-092
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10028486700
—
NE
01
—
2018022116
CERTIFIED NURSE PRACTITIONER
MO
05
—
30004629400001
—
KS
01
—
403000028
PTAN
KS
01
—
F06181383
AMERICAN ACADEMY OF NURSE PRACTITIONERS
MO
Enumeration date
07/03/2018
Last updated
03/02/2026
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