Regina Breanna Bradberry, LPN
Individual provider Active NPI Licensed Practical Nurse · Landis, NC
NPI 1831842178 · NPPES record last updated Jan 27, 2022
Key facts
- NPI
- 1831842178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 90141 (NC)
- Practice address
- 500 N Central Ave
Landis, NC 28088-1117 - Phone
- (704) 918-5671
- NPI assigned
- Jan 27, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 90141 | NC | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 90141 | NC | Yes |
Addresses
Primary practice location
500 N Central Ave
Landis, NC 28088-1117
Mailing address
349 Cooperfield Blvd Ste L
# 389
Concord, NC 28025
Phone (704) 918-5671
Other providers in Landis, NC
- Allison W. Biles
- Tianna Broome
- Daymark Recovery Services Inc
- Ranae Lashell Fletcher
- Jawanna O Gaines
- Grace Haven Care LLC
All providers in Landis, NC · Licensed Practical Nurse in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2022. 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.