Provider Demographics
NPI:1952397416
Name:BRADLEY, SYLVIA ANNE (NP-C)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ANNE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6986 DOVE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-7750
Mailing Address - Country:US
Mailing Address - Phone:972-442-1930
Mailing Address - Fax:
Practice Address - Street 1:8615 LULLWATER DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-4754
Practice Address - Country:US
Practice Address - Phone:214-221-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO175479363LA2200X
TX678069363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health