Wanda Bradshaw

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

300196 Issued in NC

Practice address

1348 Sanford Rd
Pittsboro, NC 27312-9428

Phone

(919) 545-2224

NPI assigned

Sep 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Wanda Elizabeth Bradshaw Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: wbradshaw195139@direct.conehealth.com

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1689075111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 SANFORD RD",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273129428",
            "telephone_number": "919-545-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 SANFORD RD",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273129428",
            "telephone_number": "919-545-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "WANDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "45932",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NC",
            "license": "300196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "BRADSHAW",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Benjamin Koren, D.D.S. IV, P.a.
• Lunise Benjamin, NP
• Cristina Ululani Roxanne Bensley, MSW, LCSW
• Jerrie Schmalzer Blacklin, M.S. C.C.C.
• Ruth Ellen Boone, CNM
• Jennifer Brannon, LCSW
• Ashley Bray, LCMHCA
• Marlena L Brokob
• Christy Michaela Brown, DPT
• Sandra Buck, M.S. CCC-SLP

• Neonatal Nurse Practitioner in Pittsboro, NC
• Providers in Pittsboro, NC by specialty
• Neonatal Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.