Provider Demographics
NPI:1922128537
Name:BRADBURY, NATASHIA MARIE (RN, BSN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:NATASHIA
Middle Name:MARIE
Last Name:BRADBURY
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 BLACK BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2132
Mailing Address - Country:US
Mailing Address - Phone:978-455-2496
Mailing Address - Fax:
Practice Address - Street 1:3 N MARTIN RD
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-4405
Practice Address - Country:US
Practice Address - Phone:978-473-3426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263812163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABU6453Medicaid