Shameitha Shanta Bradford, LPN
Individual provider Active NPI Licensed Practical Nurse · Baton Rouge, LA
NPI 1720104599 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720104599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 240779 (LA)
- Practice address
- 3843 Harding Blvd
Baton Rouge, LA 70807-5224 - Phone
- (225) 359-9315
- Fax
- (225) 359-9326
- NPI assigned
- Mar 22, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 240779 | LA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 240779 | LA | Yes |
Addresses
Primary practice location
3843 Harding Blvd
Baton Rouge, LA 70807-5224
Mailing address
3843 Harding Blvd
Baton Rouge, LA 70807-5224
Phone (225) 359-9315
Other providers in Baton Rouge, LA
- Whitney H Braden
- Cassie Bradford
- Jermayne Terrell Bradford
- Joseph Duane Bradford Jr.
- Kashanna Kinyale Bradford
- Braylon Bradley
- Charles E. Bradley III
- Cindy Yolanda Bradley
- Kaliya S Bradley
- Melissa Bradley
All providers in Baton Rouge, LA · Licensed Practical Nurse in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.