Provider Demographics
NPI:1457245367
Name:HECKER, BRADLEY JAMES
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:JAMES
Last Name:HECKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9036 BOWMAN LOWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-7109
Mailing Address - Country:US
Mailing Address - Phone:828-579-4030
Mailing Address - Fax:
Practice Address - Street 1:279 RIVERBEND DR
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630
Practice Address - Country:US
Practice Address - Phone:828-579-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75500164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse