Provider Demographics
NPI:1073974747
Name:BRADLEY, KAITLIN VERONICA (DO)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:VERONICA
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KAITLIN
Other - Middle Name:VERIONICA
Other - Last Name:LARIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:614-544-1000
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-1607
Practice Address - Country:US
Practice Address - Phone:608-263-8954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71161-21207R00000X
WI71161207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine