MRS. KACY LEE BRADSHAW (NPI# 1972816593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972816593 |
| Entity Type | Individual |
| Full Name | MRS. KACY LEE BRADSHAW |
| Credential | NNP |
| Practice Address |
939 Oak St Se Salem OR 97301-3901 |
| Mailing Address |
Po Box 14001 Salem OR 97309-5014 |
| Practice Telephone | 5038143561 |
| Practice Fax Number | 5038143560 |
| Mailing Telephone | 5035612490 |
| Enumeration Date | 2010-07-24 |
| Last Update Date | 2010-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
201050101NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
939 OAK ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386682409 | Cheryl A Lugenbill | Obstetrics & Gynecology | 939 Oak St Se, Salem, OR 97301 | 2006-06-02 |
| 1548689474 | Aimee Ann Kwon | Pediatrics | 939 Oak St Se, Salem, OR 97301-3901 | 2014-04-08 |
| 1235397852 | Cindy Davis | Nurse Practitioner | 939 Oak St Se, Salem, OR 97301 | 2008-05-30 |
| 1497913602 | Kathryn Kuenzi | Nurse Practitioner | 939 Oak St Se, Salem, OR 97301-3919 | 2008-05-26 |
| 1255516910 | Matthew C Egalka | Pediatrics | 939 Oak St Se, Salem, OR 97301-3901 | 2007-12-31 |
| 1679677934 | Christopher M Traudt | Pediatrics | 939 Oak St Se, Salem, OR 97301-3901 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 363LN0005X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235397852 | Cindy Davis | Nurse Practitioner | 939 Oak St Se, Salem, OR 97301 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043686504 | Amanda L Swinehart | Nurse Practitioner | 5299 Lakeview Blvd, Lake Oswego, OR 97035-5464 | 2015-08-19 |
| 1093836934 | Dawn Mary Allen | Nurse Practitioner | 17079 Cherry Crest Ave, Lake Oswego, OR 97034-5946 | 2007-04-02 |
| 1023675022 | Megan Rochelle Tinling | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2019-05-24 |
| 1568892941 | Amy R. Snyder | Nurse Practitioner | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2013-11-20 |
| 1104177989 | Marissa Christine Macedo | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2012-09-20 |
| 1932470366 | Deanna Dykema | Nurse Practitioner | 707 Sw Gaines St, Cdrcp, Portland, OR 97239-2901 | 2012-01-17 |
| 1821397563 | Sherry Colleen Johnson | Nurse Practitioner | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2011-03-21 |
| 1992935548 | Ann M Nye | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Dncc, Portland, OR 97239-3011 | 2009-07-16 |
| 1861602013 | Laura L. Aurisy | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Department of Pediatrics.neonatology, Portland, OR 97239-3011 | 2007-05-23 |
| 1538228895 | Barbera Herzog-taft | Nurse Practitioner | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2006-12-06 |
| 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.