Individual
TIFFANY BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3131 LA CANADA ST STE 200, LAS VEGAS, NV 89169-8204
(702) 369-5582
(702) 650-5148
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3343
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20227
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962935288
—
NV
01
—
20227
STATE LICENSE
NV
Enumeration date
04/04/2017
Last updated
10/17/2022
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