Individual
MRS. AMY LYNN BRADBERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
910 E HOUSTON ST STE 100, TYLER, TX 75702-8363
(903) 526-4463
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(903) 579-9800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
692643
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311184101
—
TX
Enumeration date
10/15/2012
Last updated
03/21/2013
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