Brandy Bradshaw

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2003026467 Issued in MO

Practice address

1800 Community
Clinton, MO 64735-8804

Phone

(660) 885-8131

NPI assigned

Jan 15, 2016

Last updated

Jan 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1174980544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "BRANDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2003026467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Aaron Boan
• Danielle Davone Boguslaw, MSN APRN FNP-C
• Renee Jean Boles
• James L Bourland, DDS
• Melondy Ann Bowland, LMSW
• John D Braucher, LCSW
• Casandra Brewer, M.S. CCC-SLP
• Courtney Briggs, M.S., CCC-SLP
• Bristol Care, Inc.
• Cynthia Barron Brouk, R.D., L.D.

• Licensed Practical Nurse in Clinton, MO
• Providers in Clinton, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.