ALICON KAY BRADSHAW (NPI# 1164768834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164768834 |
| Entity Type | Individual |
| Full Name | ALICON KAY BRADSHAW |
| Credential | PMHNP |
| Practice Address |
4601 Chamberlain Ln Louisville KY 40241-1159 |
| Practice Telephone | 5023842844 |
| Mailing Telephone | 5023842844 |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2013-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
3006770 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100231860 | 05 |
| Street Address |
4601 CHAMBERLAIN LN |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40241-1159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215165626 | Northeast Christian Church | Counselor | 4601 Chamberlain Ln, Louisville, KY 40241-1159 | 2009-06-24 |
| 1902311129 | Traci Braun | Counselor | 4601 Chamberlain Ln, Louisville, KY 40241-1159 | 2017-12-11 |
| 1750710521 | Julie Etherton | Marriage & Family Therapist | 4601 Chamberlain Ln, Louisville, KY 40241-1159 | 2013-11-02 |
| 1740569888 | Michelle Wren | Marriage & Family Therapist | 4601 Chamberlain Ln, Louisville, KY 40241-1159 | 2011-08-08 |
| 1235437484 | Andrea Dawn Williams | Counselor | 4601 Chamberlain Ln, Louisville, KY 40241-1159 | 2011-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1164990396 | Tiffany Elizabeth Gallucci | Nurse Practitioner | 4915 Norton Healthcare Boulevard, Louisville, KS 40241 | 2018-11-06 |
| 1952876146 | Ashley Lynne Johnson Belcher | Psychologist | 9700 Park Plaza Avenue, Ste. 106, Louisville, KY 40241 | 2018-10-04 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1346767472 | Bridgett Lin Youngblood | Case Manager/Care Coordinator | 4313 Brownsboro Glen Rd, Louisville, KY 40241 | 2017-08-29 |
| 1518375690 | Amir Shahla | Dentist | 10500 Fischer Park Dr, Louisville, KY 40241 | 2014-08-01 |
| 1255741781 | Alicia M Durham | Marriage & Family Therapist | 3900 Riveroaks Ln, Louisville, KY 40241 | 2014-05-06 |
| 1962826719 | Applied Behavioral Consulting, LLC | Community/Behavioral Health | 4517 Shenandoah Drive, Louisville, KY 40241 | 2014-02-14 |
| 1336579176 | Nicholas Weickel | Physical Therapist | 9880 Angie's Way, Suite 100, Louisville, KY 40241 | 2013-11-14 |
| Find all providers in zip 40241 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594385 | Christine Young | Nurse Practitioner | 6804 Bainbridge Ct, Louisville, KY 40228-2335 | 2020-10-07 |
| 1255948154 | Kathleen B Berghausen | Nurse Practitioner | 4112 Fern Valley Rod, Louisville, KY 40219 | 2020-09-25 |
| 1285243477 | Stephanie Atherton | Nurse Practitioner | 1623 Story Ave, Louisville, KY 40206 | 2020-07-24 |
| 1235768037 | Patricia Amber Estes | Nurse Practitioner | 234 E Gray St Ste 154, Louisville, KY 40202-1903 | 2020-04-03 |
| 1659903201 | Farrah Alayne Thornsberry | Nurse Practitioner | 1400 Browns Ln Ste B, Louisville, KY 40207-4696 | 2020-02-11 |
| 1376101634 | Erin Lee Srader | Nurse Practitioner | 544 Baxter Ave, Louisville, KY 40204-1784 | 2019-06-03 |
| 1104387752 | Kurt F Kristiansen | Nurse Practitioner | 1862 Douglass Blvd, Louisville, KY 40205-1851 | 2019-03-27 |
| 1831573351 | Karen P Black | Nurse Practitioner | 4504 Spring Bay Ct, Louisville, KY 40241-1773 | 2015-07-14 |
| 1366787798 | Kennetha Porter | Nurse Practitioner | 4710 Champions Trace Ln Ste 102, Louisville, KY 40218-3496 | 2012-12-12 |
| 1407104128 | Tammy Rowland Reddington | Nurse Practitioner | 4004 Hurstbroune Woods Drive, Louisville, KY 40299 | 2012-08-28 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40241 |
Please comment or provide details below to improve the information on ALICON KAY BRADSHAW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.