Individual
JACQUELINE ALANA BRADNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
622 W 168TH ST PH 8E-101, NEW YORK, NY 10032-3720
(212) 342-2845
Mailing address
69 COLONIAL AVE, WARWICK, NY 10990-3103
(303) 641-1523
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F431192
NY
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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