Provider Demographics
NPI:1578806899
Name:BRADNEY, LAURA ANN (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:BRADNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 SPRINGHILL DR STE 245
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2926
Mailing Address - Country:US
Mailing Address - Phone:501-945-4422
Mailing Address - Fax:501-945-4424
Practice Address - Street 1:3401 SPRINGHILL DR STE 245
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2926
Practice Address - Country:US
Practice Address - Phone:501-945-4422
Practice Address - Fax:501-945-4424
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE12533208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery