MRS. KIMBERLY L. BRADLEY APRN FNP-BC NPI 1265939185

NPI Information

NPI: 1265939185
Provider Name: MRS. KIMBERLY L. BRADLEY, APRN, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1340 SW BERTHA BLVD STE 103
PORTLAND, OR
ZIP 97219
Phone: (888) 984-7277
Get Directions

MRS. Kimberly L. Bradley, APRN, FNP-BC is a family nurse practitioner in Portland, OR with 7 years of experience. MRS. Kimberly L. Bradley, APRN, FNP-BC NPI is 1265939185. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: INDIANA MEDICAL COLLEGE, SCHOOL OF MEDICINE OF PURDUE UNIVERSITY
Graduation Year:2017

The provider's business location address is:

1340 SW BERTHA BLVD STE 103
PORTLAND, OR
ZIP 97219-096
Phone: (888) 984-7277
Fax: (833) 989-2307

The NPI 1265939185 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/8/2018 and was last updated on 12/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	201807766NP	OREGON	No
2	363LP2300X	Nurse Practitioner	Primary Care	95010714	CALIFORNIA	No
3	363LF0000X	Nurse Practitioner	Family	201807766NP	OREGON	Yes
4	261QU0200X	Clinic/Center	Urgent Care	201807766NP	OREGON	No
5	363LC1500X	Nurse Practitioner	Community Health	95010714	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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