CHARLES BRADFORD FNP-BC NPI 1194281584

NPI Information

NPI: 1194281584
Provider Name: CHARLES BRADFORD, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: ST LOUIS UNIVERSITY

PECOS Registration: Yes

Address:
1201 S GRAND BLVD
SAINT LOUIS, MO
ZIP 63104
Phone: (314) 977-4440
Get Directions

Charles Bradford, FNP-BC is a family nurse practitioner in Saint Louis, MO with 7 years of experience. Charles Bradford, FNP-BC NPI is 1194281584. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1201 S GRAND BLVD
SAINT LOUIS, MO
ZIP 63104-016
Phone: (314) 977-4440
Fax: (314) 977-3370

The NPI 1194281584 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 2/11/2019 and was last updated on 3/12/2021.

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	363LF0000X	Nurse Practitioner	Family	2018033937	MISSOURI	Yes
2	363LF0000X	Nurse Practitioner	Family	209.018613	ILLINOIS	No
3	363LG0600X	Nurse Practitioner	Gerontology	2017037322	MISSOURI	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: 11/14/2023

NPI Synchronization or Removal

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