Margie Dianne Bradshaw, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P260448 Issued in MS

Practice address

823 Jeff Goodwin St
Brandon, MS 39042-8763

Phone

(601) 825-7945

Fax

(601) 825-7945

NPI assigned

Jan 8, 2007

Last updated

Jul 8, 2007By 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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225186372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 JEFF GOODWIN ST",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390428763",
            "telephone_number": "601-825-7945",
            "fax_number": "601-825-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 JEFF GOODWIN ST",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390428763",
            "telephone_number": "601-825-7945",
            "fax_number": "601-825-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "MARGIE",
        "middle_name": "DIANNE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "P260448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Gaston Box, PHARM.D.
• Jasmonique Boyd, LMSW
• Savanna Boyd
• Kailee Boylan
• Reed Evan Bradford, PH.D.
• Amelia Bragg, LMSW
• Brandon Clinic
• Brandon Discount Drugs Inc
• Brandon Discount Drugs Inc (Brandon Discount Drugs)
• Brandon Family Chiropractic LLC

• Licensed Practical Nurse in Brandon, MS
• Providers in Brandon, MS by specialty
• Licensed Practical Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.