| NPI | 1740775121 |
|---|---|
| Former Name | MAREN K BRADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP10201) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 142483) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2018-09-30 |