Individual
JENNIFER BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3920 ST FRANCIS WAY STE 100, LAFAYETTE, IN 47905-4917
(765) 428-5990
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(131) 752-8480
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25973
SC
363LF0000X
Family Nurse Practitioner
71010119A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
25973
SC
363LP2300X
Primary Care Nurse Practitioner
28186289A
IN
Other
Enumeration date
05/08/2020
Last updated
06/27/2025
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