Trine Bradshaw, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-17897 Issued in AZ

Practice address

9709 E Impala Ave
Mesa, AZ 85209-7044

Phone

(480) 242-5588

NPI assigned

Jan 11, 2016

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1396101077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 E IMPALA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852097044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 E IMPALA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852097044",
            "telephone_number": "480-242-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "TRINE",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "AZ",
            "license": "L-17897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda L. Bradshaw, M.S., CCC-SLP
• Amber P Bradshaw
• Daniel Bradshaw, RPH
• Robert Lynn Bradshaw, D.C.
• Shannon Kay Bradshaw
• Catherine Sue Bradway, MSN, APRN, BC
• Jean Marie Brady, DENTAL HYGIENIST
• Kristiana Brady
• Robyn Elouise Brady, MA, CCC-SLP
• Mirranda Braford

• Lactation Consultant (Non-RN) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Lactation Consultant (Non-RN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.