Individual
DEBORAH BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, PSYCHOLOGIST
Contact information
Practice address
1100 WALNUT ST, OWENSBORO, KY 42301-2956
(270) 689-6500
Mailing address
1100 WALNUT ST, OWENSBORO, KY 42301-2956
(270) 689-6500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
130764
KY
363L00000X
Nurse Practitioner
Primary
3003911
KY
363L00000X
Nurse Practitioner
3911P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100155960
—
KY
Enumeration date
06/12/2006
Last updated
12/14/2016
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