Provider Demographics
NPI:1659714327
Name:BRADLEY, APRIL NICOLE (LAC, AP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:NICOLE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:LAC, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 FIG CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5940
Mailing Address - Country:US
Mailing Address - Phone:850-231-6000
Mailing Address - Fax:
Practice Address - Street 1:57 UPTOWN GRAYTON CIR STE E
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-8814
Practice Address - Country:US
Practice Address - Phone:850-231-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN224171100000X
FL3740171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist