Provider Demographics
NPI:1871821207
Name:BRADLEY, DENISE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:1021 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2713
Mailing Address - Country:US
Mailing Address - Phone:215-343-0366
Mailing Address - Fax:
Practice Address - Street 1:1021 SURREY LN
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2713
Practice Address - Country:US
Practice Address - Phone:215-343-0366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010599363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health