Provider Demographics
NPI:1164770533
Name:BRADSHAW, BRITTANY ROSS (PHARMD, RPH)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:ROSS
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5631 CREEDMOOR RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6316
Mailing Address - Country:US
Mailing Address - Phone:919-782-7330
Mailing Address - Fax:
Practice Address - Street 1:5631 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6316
Practice Address - Country:US
Practice Address - Phone:919-782-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist