Individual
AMANDA B BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP, FNP
Contact information
Practice address
5201 HARRY HINES BLVD, DALLAS, TX 75235-7708
(214) 590-7204
Mailing address
2558 MIDDLETON DR, FRISCO, TX 75033-7307
(214) 938-6577
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
705739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198106002
—
TX
05
—
198106003
—
TX
05
—
198106005
—
TX
05
—
198106006
—
TX
05
—
198106007
—
TX
Enumeration date
10/07/2008
Last updated
07/21/2022
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