Christalyn Bradshaw, RN

Individual provider Active NPI Registered Nurse · Williamstown, NJ

NPI 1104351790 · NPPES record last updated Apr 21, 2017

Key facts

NPI
1104351790
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
26NR15122800 (NJ)
Practice address
1708 Summersweet Dr
Williamstown, NJ 08094-3391
Phone
(856) 625-0465
NPI assigned
Apr 21, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR15122800NJMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR15122800 NJ Yes

Addresses

Primary practice location

1708 Summersweet Dr
Williamstown, NJ 08094-3391

Mailing address

1708 Summersweet Dr
Williamstown, NJ 08094-3391
Phone (856) 625-0465

Other identifiers

IdentifierTypeStateIssuer
1003356452OtherPAPERSONAL CARE HOME C & G

Other providers in Williamstown, NJ

All providers in Williamstown, NJ · Registered Nurse in New Jersey

Sources for this page

Verify at the official NPI Registry.