Provider Demographics
NPI:1437455128
Name:BRADSHAW, HEATHER CAIA (WHNP, ANP, DNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:CAIA
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:WHNP, ANP, DNP
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:CAIA
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WHNP,ANP, DNP
Mailing Address - Street 1:1900 S COULTER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1784
Mailing Address - Country:US
Mailing Address - Phone:806-350-7312
Mailing Address - Fax:
Practice Address - Street 1:1900 S COULTER ST
Practice Address - Street 2:SUITE B
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1784
Practice Address - Country:US
Practice Address - Phone:806-350-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX766495363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health