Provider Demographics
NPI:1497094544
Name:BRADLEY, KAREN SUE
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:BRADLEY
Suffix:
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 1:3664 E AMARILLO WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-4320
Mailing Address - Country:US
Mailing Address - Phone:480-633-5673
Mailing Address - Fax:
Practice Address - Street 1:3664 E AMARILLO WAY
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-4320
Practice Address - Country:US
Practice Address - Phone:480-633-5673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-10
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula