Bradford, Constance M

Bradford, Constance M is an individual health care provider with primary practice located at 314 Main Street Suite B, Monticello MS 39654. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bradford, Constance M can be contacted via phone (601) 393-1953.

Contact Information

Primary practice address
314 Main Street Suite B Monticello MS 39654
Phone: (601) 393-1953
Fax: (601) 393-1954
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X R878491 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R878491 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 878491 Mississippi

Profile Details

NPI number 1003960907
LBN Legal business name Bradford, Constance M
Credentials RN, FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Oct 3rd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003960907 NPPES
Mississippi MEDICAID 01980539

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