Provider Demographics
NPI:1437930443
Name:BRADLEY, DARLENE I
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:BRADLEY
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1972 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2636
Mailing Address - Country:US
Mailing Address - Phone:330-203-5977
Mailing Address - Fax:
Practice Address - Street 1:1972 EAST AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-2636
Practice Address - Country:US
Practice Address - Phone:330-203-5977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant