Provider Demographics
NPI:1255131587
Name:BRADLEY, DEVIN
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-2242
Mailing Address - Country:US
Mailing Address - Phone:402-637-7108
Mailing Address - Fax:
Practice Address - Street 1:503 GRANT ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-2242
Practice Address - Country:US
Practice Address - Phone:402-637-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant