Provider Demographics
NPI:1396378741
Name:BRADSHAW, APRIL CORELLIA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:CORELLIA
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2662
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-8662
Mailing Address - Country:US
Mailing Address - Phone:785-766-2544
Mailing Address - Fax:
Practice Address - Street 1:1301 KS HIGHWAY 264
Practice Address - Street 2:1301 KS HIGHWAY 264
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550
Practice Address - Country:US
Practice Address - Phone:620-285-4580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79153-051363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner