Kristin R Bradley, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704224909 Issued in MI

Practice address

2215 44TH St SW
Wyoming, MI 49519-6439

Phone

(616) 252-8300

Fax

(616) 252-8460

NPI assigned

Mar 13, 2008

Last updated

Nov 17, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristin R Schoenfeldt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1669643060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 BRETON RD SE",
            "address_2": "SUITE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 44TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495196439",
            "telephone_number": "616-252-8300",
            "fax_number": "616-252-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KRISTIN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704224909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669643060",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "SCHOENFELDT",
            "middle_name": "R",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ineciyah Bracey
• Marie L Brackett, BS
• Kevin R Brader, MD
• Amy Joy Bradley, LPN
• John S Bradley, D.O.
• Emelia Branham, DPT
• Hannah Christine Bredeweg
• Jason J Breen, SLP
• Cassidy Bremmer, NP
• Jill Bresson, LPN

• Nurse Practitioner in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.