Bradley, Tajuana B

Bradley, Tajuana B is an individual health care provider with primary practice located at 698 Duluth Hwy Ste 201 , Lawrenceville GA 30046-7648. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Bradley, Tajuana B can be contacted via phone (770) 822-0788.

Contact Information

Primary practice address
698 Duluth Hwy Ste 201 Lawrenceville GA 30046-7648
Phone: (770) 822-0788
Fax: (770) 822-0326
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN148400 Georgia

Profile Details

NPI number 1215266358
LBN Legal business name Bradley, Tajuana B
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2009
Last updated Aug 25th, 2020 - about 4 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 1215266358 NPPES
Georgia MEDICAID 215815240E
Georgia MEDICAID 215815240F
Georgia Other 202I502094

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