Lisa Bradley, LPN

Individual provider Active NPI Licensed Practical Nurse · Jackson, OH

NPI 1477066645 · NPPES record last updated Nov 10, 2017

Key facts

NPI
1477066645
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN.078167 (OH)
Practice address
500 Burlington Rd Ste 240
Jackson, OH 45640-9360
Phone
(740) 286-5075
Fax
(740) 395-8411
NPI assigned
Nov 10, 2017
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

LicenseStateTypeSpecialty
LPN.078167OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.078167 OH Yes

Addresses

Primary practice location

500 Burlington Rd Ste 240
Jackson, OH 45640-9360

Mailing address

1049 Western Ave
Chillicothe, OH 45601-1104
Phone (740) 773-4366

Other providers in Jackson, OH

All providers in Jackson, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.