Individual provider · Type 1 NPI
Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C
Family Nurse Practitioner · Grand Rapids, MI
NPI number
1124624465
Active
Practice location
1752 Southampton Dr SE
Grand Rapids, MI 49508-2647
Mailing address
PO Box 1268
Grand Rapids, MI 49501-1268
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 4704251077 (MI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1124624465
Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C's National Provider Identifier is 1124624465, issued on Dec 10, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Grand Rapids, MI. The record was last updated on Dec 10, 2020.