Amy Lynn Bradbery, RN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

692643 Issued in TX

Practice address

910 E Houston St Ste 100
Tyler, TX 75702-8363

Phone

(903) 526-4463

NPI assigned

Oct 15, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1679825640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "903-579-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E HOUSTON ST STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028363",
            "telephone_number": "903-526-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBERY",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "692643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311184101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Leon Boyne, M.D.
• Benjamin Daniel Boynton, PH.D.
• Amanda Boze
• Lucas Bozick
• Jessica Bracks, MD
• Braden Partners LP
• Kenneth Bradford, D.D.S.
• Victoria Bradford
• Casandra Bradley
• Dale J Bradley, D.O.

• Family Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.