CRYSTAL BRADLEY (NPI# 1306447263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306447263 |
| Entity Type | Individual |
| Full Name | CRYSTAL BRADLEY |
| Credential | FNP-C |
| Practice Address |
9447 Holy Cross Ln Breese IL 62230-3510 |
| Practice Telephone | 6185262209 |
| Mailing Telephone | 6185262209 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209022274 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205470135 | Crystal Bradley | Social Worker | 24 Seals Dr, Monroe, NY 10950-3949 | 2019-11-04 |
| 1316126659 | Crystal Marie Bradley | Counselor | 315 Hudson St Fl 2, New York, NY 10013-1040 | 2007-11-02 |
| 1578024188 | Crystal Sweeting Bradley | Nurse Practitioner | 5656 Kelley St, Houston, TX 77026-1967 | 2019-03-27 |
| 1770943730 | Crystal Bradley | Dietitian, Registered | 1 Barnes Hospital Plz, Saint Louis, MO 63110-1003 | 2016-03-03 |
| 1134456080 | Crystal Renee Bradley | Pharmacist | 5049 Preston Rd, Frisco, TX 75034-7401 | 2009-11-13 |
| Street Address |
9447 HOLY CROSS LN |
| City | BREESE |
| State | IL |
| Zip Code | 62230-3510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467419804 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2006-04-28 |
| 1669986121 | Megan Lynn Schniers | Advanced Practice Midwife | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2017-11-20 |
| 1720417413 | Breck D Kramper | Nurse Practitioner | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2013-11-04 |
| 1174887277 | Southern Obstetric & Gyneco Associates | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2012-07-03 |
| 1316148364 | Bonnie M Gelly | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2007-05-29 |
| 1386602134 | Nancy Jane Taylor | Nurse Practitioner | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2006-05-02 |
| 1881652626 | Anne Doll-pollard | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2006-05-02 |
| 1629035076 | Penny Sue Gozia | Obstetrics & Gynecology | 9447 Holy Cross Ln, Breese, IL 62230-3510 | 2006-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841738457 | Coping 4 Kids | Social Worker | 900 N Walnut St., Breese, IL 62230 | 2017-02-02 |
| 1528505146 | Danielle Mueller | Licensed Practical Nurse | 604 North Chestnut, Breese, IL 62230 | 2017-01-20 |
| 1104000561 | Competitive Edge Sports Medicine | Family Medicine | 14160 Jamestown Rd, Breese, IL 62230 | 2007-12-20 |
| 1063606978 | Clarkson Optometry Illinois PC | Optometrist | 103 Clintonian Plaza, Breese, IL 62230 | 2007-09-04 |
| 1013002658 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Family Medicine | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2006-10-03 |
| 1730287434 | Breese Dental Group PC. | Dentist | 9437 Holy Cross Ln., Breese, IL 62230 | 2006-09-20 |
| 1144328832 | Joe Cao Truong | Dentist | 9437 Holy Cross Lane, Breese, IL 62230 | 2006-09-20 |
| 1356391155 | Timothy H Droege | Dentist | 111 North Main, Breese, IL 62230 | 2006-05-11 |
| 1346206042 | Thomas B Doyle | Radiology | 9515 Holy Cross Lane, Breese, IL 62230 | 2006-04-22 |
| 1346730561 | Amanda Walden | Nurse Practitioner | 9401 Holy Cross Ln Ste 112, Breese, IL 62230 | 2018-05-14 |
| Find all providers in zip 62230 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821537820 | Talisha Nyman | Nurse Practitioner | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2017-02-23 |
| 1780127258 | Deanne Perez-meskil | Nurse Practitioner | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2016-11-30 |
| 1396087599 | Amanda Nichole Korte | Nurse Practitioner | 9423 Holy Cross Ln, Suite 111, Breese, IL 62230-3510 | 2013-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
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| 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.