Individual
MISS TORI BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN,RN
Contact information
Practice address
328 SPENCE STREET, NORRIS CITY, IL 62869
(618) 384-1141
Mailing address
PO BOX 301, NORRIS CITY, IL 62869-0301
(618) 384-1141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
014166545
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SCHOOL
SCHOOL
IL
Enumeration date
11/15/2021
Last updated
11/16/2021
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