Amanda Jo Bradley
Individual provider Active NPI Nurse's Aide · Kayenta, AZ
NPI 1326698283 · NPPES record last updated Sep 12, 2019
Key facts
- NPI
- 1326698283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 227109 (AZ)
- Practice address
- Kayenta Health Center
US Hwy 160 M.P. 394.3
Kayenta, AZ 86033 - Phone
- (928) 697-4000
- NPI assigned
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227109 | AZ | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 227109 | AZ | Yes |
Addresses
Primary practice location
Kayenta Health Center
US Hwy 160 M.P. 394.3
Kayenta, AZ 86033
Mailing address
PO Box 4506
Kayenta, AZ 86033-4506
Phone (602) 825-0788
Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.