Louanna Marie Bradley, M.S., A.P.N-C

Individual provider Active NPI Family Nurse Practitioner · Rock Springs, WY

NPI 1295830743 · NPPES record last updated Jan 9, 2008

Key facts

NPI
1295830743
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
17326.0728 (WY)
Practice address
3000 College Dr
Suite a
Rock Springs, WY 82901-4202
Phone
(307) 362-1861
Fax
(307) 362-1277
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17326.0728WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Frontier Imaging, LLC Family Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17326.0728 WY Yes

Addresses

Primary practice location

3000 College Dr
Suite a
Rock Springs, WY 82901-4202

Mailing address

3000 College Dr
Suite a
Rock Springs, WY 82901-4202
Phone (307) 362-1861

Other identifiers

IdentifierTypeStateIssuer
107037100MedicaidWY

Other providers in Rock Springs, WY

All providers in Rock Springs, WY · Family Nurse Practitioner in Wyoming

Sources for this page

Verify at the official NPI Registry.