Dorothy Arlene Bradbury, C.R.N.A.
Individual provider Active NPI Certified Registered Nurse Anesthetist · Lafayette, IN
NPI 1831178086 · NPPES record last updated Feb 1, 2008
Key facts
- NPI
- 1831178086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 28108014A (IN)
- Practice address
- 2600 Greenbush St
Lafayette, IN 47904-2479 - Phone
- (765) 448-8000
- NPI assigned
- Jan 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28108014A | IN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Lakes Anesthesia, P.C. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 28108014A | IN | Yes |
Addresses
Primary practice location
2600 Greenbush St
Lafayette, IN 47904-2479
Mailing address
PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9419433 | Other | IN | PHCS PID NUMBER |
| 000000391621 | Other | IN | ANTHEM PROVIDER NUMBER |
| 11253449 | Other | IN | CAQH NUMBER |
Other providers in Lafayette, IN
- Kelsey Bower
- David Alan Bowman
- Karisa Bowman
- Kelly Boyd
- Brooke Lynae Boyer
- Jennifer Bradley
- Aaron M. Braithwaite
- Christopher Brandenburg
- Nathan Evan Brandley
- Vella R Branstetter
All providers in Lafayette, IN · Certified Registered Nurse Anesthetist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2008. 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.