NPI 1164856993 · live from the CMS NPI Registry
Colleen Ann Bradford, PNP
Nurse Practitioner in Saint Louis, MO. National Provider Identifier 1164856993, active.
NPI record
| NPI | 1164856993 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 456 N New Ballas Rd, Ste 304, Saint Louis, MO 63141 |
| Practice phone | 314-567-6868 |
| Enumerated | August 28, 2013 |
| Last updated | May 9, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | 2017036482 (MO) |
| Nurse Practitioner primary | 363L00000X | 2017036482 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.