Individual
MS. TINA F BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
(678) 212-6350
Mailing address
5069 NISBET DR, MACON, GA 31206-4721
(478) 788-7856
(478) 788-7856
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN083905
GA
Other
Enumeration date
02/22/2013
Last updated
02/22/2013
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