Provider Demographics
NPI:1508879875
Name:BRADLEY, JANICE J (NP)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:J
Last Name:BRADLEY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 RANGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-5273
Mailing Address - Country:US
Mailing Address - Phone:817-528-5491
Mailing Address - Fax:
Practice Address - Street 1:1005 S CROWLEY RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4282
Practice Address - Country:US
Practice Address - Phone:817-297-4455
Practice Address - Fax:817-295-3022
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX647046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily