Individual provider · NPI-1

Shannon Bradley, RN

Registered Nurse · Arlington, TX

NPI number1679263305

StatusActive

Last updated in NPPESMay 8, 2023

Details

NPI: 1679263305
Entity type: Individual (NPI-1)
Name: Ms. Shannon Bradley
Credential: RN
Sex: Female
Sole proprietor: No
Enumeration date: May 8, 2023
Certification date: May 8, 2023
Last updated: May 8, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163W00000X	Registered Nurse	666347	TX	Yes
163WC0400X	Registered Nurse, Case Management	666347	TX
163WD0400X	Registered Nurse, Diabetes Educator	666347	TX

Practice location

1601 E Lamar Blvd Ste 209
Arlington, TX 76011-4464

Phone 817-766-6030 · Fax 817-766-5942

Mailing address

1601 E Lamar Blvd Ste 209
Arlington, TX 76011-4464

Phone 817-766-6030 · Fax 817-766-5942

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.