Provider Demographics
NPI:1356986343
Name:BRADLEY, CASEY J (DOULA)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:J
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51503 TAOS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-2271
Mailing Address - Country:US
Mailing Address - Phone:336-404-3881
Mailing Address - Fax:
Practice Address - Street 1:51503 TAOS ST APT 1
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-2271
Practice Address - Country:US
Practice Address - Phone:336-404-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula