Provider Demographics
NPI:1386029882
Name:BRADLEY, SARAH CREED (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CREED
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E DEKALB ST STE C
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-4432
Mailing Address - Country:US
Mailing Address - Phone:803-713-0806
Mailing Address - Fax:803-713-0769
Practice Address - Street 1:110 E DEKALB ST STE C
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-4432
Practice Address - Country:US
Practice Address - Phone:803-713-0806
Practice Address - Fax:803-713-0769
Is Sole Proprietor?:No
Enumeration Date:2015-07-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19273363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care