Individual
JESSICA CRUZ BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
205719
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
20239
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2575
—
SC
Enumeration date
04/19/2016
Last updated
02/02/2022
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