Individual
KATRINA ELIZABETH BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2833 BELLA VISTA WAY, BELLA VISTA, AR 72714-3709
(479) 876-2153
(479) 876-2184
Mailing address
2171 BUCK CV, PEA RIDGE, AR 72751-5000
(479) 426-0614
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD14611
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD14611
PHARMACIST LICENSE
AR
Enumeration date
07/25/2018
Last updated
07/25/2018
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