HOLLY BRADFORD (NPI# 1710439047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710439047 |
| Entity Type | Individual |
| Full Name | HOLLY BRADFORD |
| Credential | NP |
| Practice Address |
4111 Franklin St Michigan City IN 46360-7803 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 2198732919 |
| Practice Fax Number | 2198732909 |
| Mailing Telephone | 3175284800 |
| Mailing Fax Number | 3178651479 |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2019-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71006753A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
28203078A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201407950 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1225 E Coolspring Ave, Michigan City, IN 463606312 | 2198732919 | 2198732909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164952974 | Holly A Bradford | Dentist | 1669 E Main St, Danville, IN 46122-9468 | 2017-06-14 |
| Street Address |
4111 FRANKLIN ST |
| City | MICHIGAN CITY |
| State | IN |
| Zip Code | 46360-7803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952396772 | Cheryl Krueger | Family Medicine | 4111 Franklin St, Michigan City, IN 46360-7803 | 2005-09-19 |
| 1952950560 | Kristen M Garza | Nurse Practitioner | 4111 Franklin St, Michigan City, IN 46360-7803 | 2019-09-06 |
| 1780145904 | Jason Bruno | Nurse Practitioner | 4111 Franklin St, Michigan City, IN 46360-7803 | 2019-03-29 |
| 1033527874 | Michael Owolabi | Emergency Medicine | 4111 Franklin St, Michigan City, IN 46360 | 2014-07-24 |
| 1205971165 | Steven Dale Whaley | Preventive Medicine | 4111 Franklin St, Michigan City, IN 46360-7803 | 2007-02-20 |
| 1770679052 | Kristin Osan | Physician Assistant | 4111 Franklin St, Michigan City, IN 46360-7803 | 2006-10-05 |
| 1376568600 | Robert P Marino | Family Medicine | 4111 Franklin St, Michigan City, IN 46360 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821649096 | Trinity Healthcare Inc. | Occupational Therapist | 4300 Cleveland Ave, Michigan City, IN 46360 | 2019-09-27 |
| 1861905499 | Erika Leigh Maroon | Chiropractor | 8690 West Pahs Rd., Michigan City, IN 46360 | 2017-11-06 |
| 1750740650 | Michelle Asbell | Nurse Practitioner | 301 Homer St, Michigan City, IN 46360 | 2016-02-19 |
| 1235523952 | Marnee Flinn-smith | Specialist/Technologist | 8466 Pahs Rd, Michigan City, IN 46360 | 2015-03-19 |
| 1184976359 | Kelly Stewart | Physical Therapist | 301 Homer Street, Michigan City, IN 46360 | 2012-10-11 |
| 1053660936 | Planned Parenthood of Indiana Michigan City | Clinic/Center | 324 Dunes Plaza, Michigan City, IN 46360 | 2012-09-06 |
| 1114288644 | June R. R. Nichols Ocularist, Ltd | Durable Medical Equipment & Medical Supplies | 450 St. John Road, Suite 396, Michigan City, IN 46360 | 2012-05-31 |
| 1083980858 | Enoch Kassa | Internal Medicine | 3777 N Frontage Rd, Michigan City, IN 46360 | 2012-03-27 |
| 1760768196 | American Limb & Orthopedic Company of Valparaiso | Prosthetic/Orthotic Supplier | 3777 N. Frontage Rd, Suite 100, Michigan City, IN 46360 | 2011-10-31 |
| 1801181144 | Elizabeth A Whitaker | Counselor | 8733 W. 400 N., 400 North Medical Center, Michigan City, IN 46360 | 2011-06-15 |
| Find all providers in zip 46360 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750740650 | Michelle Asbell | Nurse Practitioner | 301 Homer St, Michigan City, IN 46360 | 2016-02-19 |
| 1396344487 | Daniel Cole | Nurse Practitioner | 3500 Franciscan Way, Michigan City, IN 46360-0021 | 2020-10-20 |
| 1104423326 | Janel Marie Zilinski | Nurse Practitioner | 3500 Franciscan Way, Michigan City, IN 46360-0021 | 2020-10-01 |
| 1710548706 | Monica Almy-boylan | Nurse Practitioner | 601 W Kieffer Rd, Michigan City, IN 46360-9599 | 2019-06-21 |
| 1790272409 | Walter R Corder | Nurse Practitioner | 8733 W 400 N, Michigan City, IN 46360-9330 | 2018-04-18 |
| 1972005809 | Lisa Varnado | Nurse Practitioner | 3500 Franciscan Way Ste 400, Michigan City, IN 46360-0021 | 2018-03-07 |
| 1174024939 | Carolyn Mae Blouir | Nurse Practitioner | 1507 Wabash St, Michigan City, IN 46360 | 2018-02-26 |
| 1508261728 | Jacqueline Cooke | Nurse Practitioner | 9856 W 400 N, Michigan City, IN 46360-2910 | 2014-10-30 |
| 1013359942 | Jason C Little | Nurse Practitioner | 3500 Franciscan Way, Michigan City, IN 46360 | 2013-07-19 |
| 1104269166 | Stephanie M Andree | Nurse Practitioner | 10176 W 400 N, Michigan City, IN 46360-9008 | 2013-04-09 |
| Find all providers in MICHIGAN CITY | ||||
| City | MICHIGAN CITY |
| Zip Code | 46360 |
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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.