MS. EDDIE RUTH BRADFORD FNP NPI 1366599508

NPI Information

NPI: 1366599508
Provider Name: MS. EDDIE RUTH BRADFORD, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
777 ISLE OF CAPRI PKWY
LULA, MS
ZIP 38644
Phone: (662) 337-4554
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MS. Eddie Ruth Bradford, FNP is a family nurse practitioner in Lula, MS. MS. Eddie Ruth Bradford, FNP NPI is 1366599508. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

777 ISLE OF CAPRI PKWY
LULA, MS
ZIP 38644-701
Phone: (662) 337-4554
Fax: (662) 337-4564

The enumeration date for this NPI number is 1/3/2007 and was last updated on 9/4/2019.

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	R659975	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00119310	MEDICAID	MISSISSIPPI
2	191427758	MEDICAID	ARKANSAS

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: 5/5/2024

NPI Synchronization or Removal

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