Individual
MRS. KRISTIN R BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2215 44TH ST SW, WYOMING, MI 49519-6439
(616) 252-8300
(616) 252-8460
Mailing address
1925 BRETON RD SE, SUITE 201, GRAND RAPIDS, MI 49506-4810
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704224909
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669643060
—
MI
Enumeration date
03/13/2008
Last updated
11/17/2009
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