Individual provider · Type 1 NPI
Charles Bradford, FNP-BC
Family Nurse Practitioner · St. Louis, MO
NPI number
1194281584
Active
Practice location
1201 S Grand Blvd
St. Louis, MO 63104-1016
Fax (314) 977-3370
Mailing address
1008 S Spring Ave Fl 2
St. Louis, MO 63110-2520
Other practice locations
- 1225 S Grand Blvd Fl 2, St. Louis, MO 63104-1016 · (314) 977-8462
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.018613 (IL) |
| Gerontology Nurse Practitioner | 363LG0600X | 2017037322 (MO) |
| Family Nurse Practitioner Primary | 363LF0000X | 2018033937 (MO) |
Family Nurse Practitioner: Definition to come...
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About NPI 1194281584
Charles Bradford, FNP-BC's National Provider Identifier is 1194281584, issued on Feb 11, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in St. Louis, MO. The record was last updated on Mar 12, 2021.