Individual
MS. VIRGINIA BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
24 WHITE BRIDGE PIKE, NASHVILLE, TN 37205-1411
(615) 352-0011
(615) 352-0085
Mailing address
820 SPRINGER DR, LOMBARD, IL 60148-6413
(815) 744-8554
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7319
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3043372
—
TN
01
—
3046283
BCBS PROVIDER NUMBER
TN
01
—
3711015
MEDICARE PTAN
TN
Enumeration date
07/03/2006
Last updated
09/11/2024
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