Jaclyn Bradley
Individual provider Active NPI Other Technician · Roscommon, MI
NPI 1982153763 · NPPES record last updated Sep 22, 2016
Key facts
- NPI
- 1982153763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 1599 W Doyle TRL
Roscommon, MI 48653-9211 - Phone
- (989) 302-7474
- NPI assigned
- Sep 22, 2016
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
1599 W Doyle TRL
Roscommon, MI 48653-9211
Mailing address
1599 W Doyle TRL
Roscommon, MI 48653-9211
Other providers in Roscommon, MI
- Tracy Marie Bacik
- James D Balger
- Allyson Barker
- Tammy Lynn Baudoux
- Isabel Virginia Begazo Nunez
- Brian M Brausa
- Katie Ann Burmester
- C.O.O.R. Intermediate School District
- Caring Touch Nursing
- Caring Touch Nursing, Inc.
All providers in Roscommon, MI · Other Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2016. 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.