Provider Demographics
NPI:1245536879
Name:BRADSHAW, APRIL D
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:D
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:SUNNY SIDE
Mailing Address - State:GA
Mailing Address - Zip Code:30284-0362
Mailing Address - Country:US
Mailing Address - Phone:404-462-9958
Mailing Address - Fax:
Practice Address - Street 1:430 WESTSIDE DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-4876
Practice Address - Country:US
Practice Address - Phone:404-462-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-29
Last Update Date:2011-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health