Provider Demographics
NPI:1174808422
Name:COLE-BRADLEY, ANNIE COLLINS (APRN, DNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:COLLINS
Last Name:COLE-BRADLEY
Suffix:
Gender:F
Credentials:APRN, DNP, FNP-BC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 CHAD DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7428
Mailing Address - Country:US
Mailing Address - Phone:541-530-5515
Mailing Address - Fax:541-607-7431
Practice Address - Street 1:4962 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-4126
Practice Address - Country:US
Practice Address - Phone:615-874-3422
Practice Address - Fax:615-874-3465
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2019099997RN163W00000X
OR201910139NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse