Bradley, V Jean

Bradley, V Jean is an individual health care provider with primary practice located at 7910 W Jefferson Blvd Suite 300, Fort Wayne IN 46804-4159. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bradley, V Jean can be contacted via phone (260) 432-1800.

Contact Information

Primary practice address
7910 W Jefferson Blvd Suite 300 Fort Wayne IN 46804-4159
Phone: (260) 432-1800
Fax: (260) 432-1804
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71001398 Indiana

Profile Details

NPI number 1770535668
LBN Legal business name Bradley, V Jean
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Nov 5th, 2010 - about 14 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 1770535668 NPPES
Indiana MEDICAID 200406350

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