Provider Demographics
NPI:1083924583
Name:BRADFIELD, ERIC (FNP-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BRADFIELD
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 MEANY AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-5199
Mailing Address - Country:US
Mailing Address - Phone:661-843-7830
Mailing Address - Fax:661-843-7831
Practice Address - Street 1:7702 MEANY AVE STE 105
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5199
Practice Address - Country:US
Practice Address - Phone:661-843-7830
Practice Address - Fax:661-843-7831
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083924583Medicaid