Individual provider · Type 1 NPI
Crystal Bradley, FNP-C, FPA
Family Nurse Practitioner · Glen Carbon, IL
NPI number
1306447263
Active
Practice location
4260 S State Route 159 Ste 1
Glen Carbon, IL 62034-3201
Mailing address
4335 Wagner Rd
Marine, IL 62061-1253
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 277.003238 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1306447263
Crystal Bradley, FNP-C, FPA's National Provider Identifier is 1306447263, issued on Nov 5, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Glen Carbon, IL. The record was last updated on Sep 4, 2024.