Individual
KELLY NICOLE BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11201 NALL AVE, SUITE 120, LEAWOOD, KS 66211
(913) 491-4466
Mailing address
11201 NALL AVE, SUITE 120, LEAWOOD, KS 66211
(913) 491-4466
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11050
KS
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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