Provider Demographics
NPI:1740801653
Name:BRADLEY, SHARON M (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 N DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-1204
Mailing Address - Country:US
Mailing Address - Phone:269-362-4880
Mailing Address - Fax:
Practice Address - Street 1:324 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107-1204
Practice Address - Country:US
Practice Address - Phone:269-362-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care