Individual
CANDACE ANGELENA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1750 KERNERSVILLE MEDICAL PKWY, KERNERSVILLE, NC 27284-7146
(336) 564-4866
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200200649
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89133C
—
NC
05
—
89133C4
—
NC
Enumeration date
09/29/2005
Last updated
03/27/2025
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