Provider Demographics
NPI:1982316774
Name:BRADSHER, ALEXANDRA ELIZABETH (CNM)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ELIZABETH
Last Name:BRADSHER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16563 CANTREE RD
Mailing Address - Street 2:
Mailing Address - City:MC KENNEY
Mailing Address - State:VA
Mailing Address - Zip Code:23872-3019
Mailing Address - Country:US
Mailing Address - Phone:804-731-1421
Mailing Address - Fax:
Practice Address - Street 1:2007 GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2656
Practice Address - Country:US
Practice Address - Phone:434-385-8948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185681176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife