Provider Demographics
NPI:1457153538
Name:BRADFORD, CATHY (LPN)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:
Last Name:BRADFORD
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 W PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-4714
Mailing Address - Country:US
Mailing Address - Phone:443-485-6544
Mailing Address - Fax:
Practice Address - Street 1:953 W PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-4714
Practice Address - Country:US
Practice Address - Phone:443-485-6544
Practice Address - Fax:443-485-6442
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP51102164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse