Provider Demographics
NPI:1609081546
Name:BRADSHAW, JANET L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:L
Other - Last Name:FRATELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:71 PROSPECT AVE
Mailing Address - Street 2:OCCUPATIONAL HEALTH
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2907
Mailing Address - Country:US
Mailing Address - Phone:518-828-8364
Mailing Address - Fax:518-828-8029
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:OCCUPATIONAL HEALTH
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-8364
Practice Address - Fax:518-828-8029
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300608-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health