DR. NINA GRACE BRADLEY D.O. NPI 1750692422

NPI Information

NPI: 1750692422
Provider Name: DR. NINA GRACE BRADLEY, D.O.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Organization: ST. JOSEPH HOSPITAL OF NASHUA NH

PECOS Registration: Yes

Address:
9110 COLLEGE POINTE CT
FORT MYERS, FL
ZIP 33919
Phone: (239) 208-2212
Get Directions

DR. Nina Grace Bradley, D.O. is a neurology psychiatry neurology in Fort Myers, FL with 14 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Nina Grace Bradley, D.O. NPI is 1750692422. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduation Year:2010

The provider's business location address is:

9110 COLLEGE POINTE CT
FORT MYERS, FL
ZIP 33919-244
Phone: (239) 208-2212
Fax: (239) 208-3994

The NPI 1750692422 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 6/28/2010 and was last updated on 11/12/2021.

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	2084N0400X	Psychiatry & Neurology	Neurology	OS15212	FLORIDA	Yes
2	2084N0400X	Psychiatry & Neurology	Neurology	21512	NEW HAMPSHIRE	No
3	2084N0400X	Psychiatry & Neurology	Neurology	DO197423	OREGON	No
4	2084N0400X	Psychiatry & Neurology	Neurology	87299	GEORGIA	No

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	03999406	MEDICAID	NEW YORK

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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