Provider Demographics
NPI:1881409795
Name:BRADLEY, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15517 NEWELL ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-7429
Mailing Address - Country:US
Mailing Address - Phone:402-659-3713
Mailing Address - Fax:
Practice Address - Street 1:7356 FUJI PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3626
Practice Address - Country:US
Practice Address - Phone:402-890-3769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion