Individual
DENISE A. BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-6901
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18084
SC
363L00000X
Nurse Practitioner
RN219030
GA
363L00000X
Nurse Practitioner
SP006623B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116627A
—
GA
05
—
NP1933
—
SC
01
—
P01005492
RAILROAD MEDICARE
GA
Enumeration date
04/26/2006
Last updated
02/26/2019
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