Individual
BRONWYN KATHLEEN RADCLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
355 COUNTY ROAD 503, BAYFIELD, CO 81122-9305
(970) 238-0438
Mailing address
355 COUNTY ROAD 503, BAYFIELD, CO 81122-9305
(970) 238-0438
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024164985
VA
363LF0000X
Family Nurse Practitioner
Primary
100066-C-NP
CO
363LF0000X
Family Nurse Practitioner
CNP-01758
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04105061
—
CO
01
—
82-4428406
I DO NOT TAKE INSURANCE
CO
01
—
COA106458
MEDICARE PTAN
CO
Enumeration date
07/19/2006
Last updated
03/18/2020
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