Provider Demographics
NPI:1447537105
Name:BRADLEY, LORI (APRN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2M
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9466
Mailing Address - Country:US
Mailing Address - Phone:606-487-1818
Mailing Address - Fax:606-487-8448
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2M
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9466
Practice Address - Country:US
Practice Address - Phone:606-487-1818
Practice Address - Fax:606-487-8448
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2024-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3007224363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner