Provider Demographics
NPI:1174342927
Name:BRADSHAW, RIANNON (CD)
Entity type:Individual
Prefix:
First Name:RIANNON
Middle Name:
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18686 E ORIOLE WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5538
Mailing Address - Country:US
Mailing Address - Phone:480-658-8522
Mailing Address - Fax:
Practice Address - Street 1:18686 E ORIOLE WAY
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5538
Practice Address - Country:US
Practice Address - Phone:480-658-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula