Provider Demographics
NPI:1871821322
Name:WHY, BRADLEY STANFORD (FPMHNP)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:STANFORD
Last Name:WHY
Suffix:
Gender:M
Credentials:FPMHNP
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Mailing Address - Street 1:1423 CAPITOL TRAIL DRUMMOND PLAZA OFFICE PARK
Mailing Address - Street 2:BUILDING 1, SUITE 1107
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19707
Mailing Address - Country:US
Mailing Address - Phone:302-502-3255
Mailing Address - Fax:302-502-3257
Practice Address - Street 1:1423 CAPITOL TRAIL DRUMMOND PLAZA OFFICE PARK
Practice Address - Street 2:BUILDING 1, SUITE 1107
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19707
Practice Address - Country:US
Practice Address - Phone:302-502-3255
Practice Address - Fax:302-502-3257
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0000104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000000291051Medicaid