Bradshaw, Koren H.

Bradshaw, Koren H. is an sole proprietor health care provider with primary practice located at 32 Ermine St , Fairfield CT 06824-5109. She recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Education, Other Service Providers / Lactation Consultant, Non-RN, Dietary & Nutritional Service Providers / Nutritionist. Dietary & Nutritional Service Providers / Nutritionist is her primary health care specialty. Bradshaw, Koren H. can be contacted via phone (617) 827-5223.

Contact Information

Primary practice address
32 Ermine St Fairfield CT 06824-5109
Phone: (617) 827-5223
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X
Other Service Providers / Lactation Consultant, Non-RN 174N00000X
Dietary & Nutritional Service Providers / Nutritionist 133N00000X

Profile Details

NPI number 1205308012
LBN Legal business name Bradshaw, Koren H.
Credentials MS, CLC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2018
Last updated Dec 19th, 2018 - about 7 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.

Request for update

Popular Providers