Individual
LAURI BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
30920 SOUTHFIELD RD, SOUTHFIELD, MI 48076-7738
(248) 647-7472
Mailing address
334 N MARIAS AVE, CLAWSON, MI 48017-1477
(248) 808-4909
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704269030
MI
363LF0000X
Family Nurse Practitioner
Primary
4704269030
MI
Other
Enumeration date
02/07/2021
Last updated
12/15/2021
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