Provider Demographics
NPI:1730182890
Name:BRADLEY, SHEILA DIANE (FNP)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:DIANE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:DIANE
Other - Last Name:MCGUCKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:15603 HOWELL GROVE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2277
Mailing Address - Country:US
Mailing Address - Phone:908-519-2293
Mailing Address - Fax:
Practice Address - Street 1:7401 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4509
Practice Address - Country:US
Practice Address - Phone:713-799-2300
Practice Address - Fax:833-520-1440
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129764363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200055220AMedicaid
OKQ38297Medicare UPIN
OK249712001Medicare PIN