Individual
BETHANY B BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-7112
(843) 792-1414
Mailing address
9263 MEDICAL PLAZA DR, STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
(843) 576-6168
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
18110
SC
390200000X
Student in an Organized Health Care Education/Training Program
100208
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2242
—
SC
Enumeration date
10/30/2012
Last updated
07/21/2022
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