Provider Demographics
NPI:1356328843
Name:BRADSHAW SCOTT, ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BRADSHAW SCOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1009 WINDCROSS CT
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2678
Mailing Address - Country:US
Mailing Address - Phone:888-584-0077
Mailing Address - Fax:888-584-0077
Practice Address - Street 1:1009 WINDCROSS CT
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2678
Practice Address - Country:US
Practice Address - Phone:888-584-0077
Practice Address - Fax:888-584-0077
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6253363LF0000X
TN76692163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3909314OtherMEDICARE
TN3909317Medicaid
TNP85847Medicare UPIN