Individual
MRS. KACY LEE BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
939 OAK ST SE, SALEM, OR 97301-3901
(503) 814-3561
(503) 814-3560
Mailing address
PO BOX 14001, SALEM, OR 97309-5014
(503) 561-2490
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
201050101NP
OR
Other
Enumeration date
07/24/2010
Last updated
07/24/2010
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