Provider Demographics
NPI:1538348560
Name:HUNT BRADLYN, PATRICIA DIANA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DIANA
Last Name:HUNT BRADLYN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:DIANA
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2780 EUREKA WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-229-0360
Mailing Address - Fax:530-229-0856
Practice Address - Street 1:2780 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-229-0360
Practice Address - Fax:530-229-0856
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN392055174400000X
CANP16086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist