Provider Demographics
NPI:1538446018
Name:BRADLEY, ZACHARY LENNON (NREMT)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:LENNON
Last Name:BRADLEY
Suffix:
Gender:M
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 BIDDLE BLVD BLDG 2101
Mailing Address - Street 2:
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-2307
Mailing Address - Country:US
Mailing Address - Phone:816-701-3213
Mailing Address - Fax:913-684-2877
Practice Address - Street 1:400 E 9TH ST STE 0040
Practice Address - Street 2:VHA- EMERGENCY MANAGEMENT
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-2607
Practice Address - Country:US
Practice Address - Phone:800-525-1483
Practice Address - Fax:816-842-0885
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No172A00000XOther Service ProvidersDriver
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No174H00000XOther Service ProvidersHealth Educator
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No374700000XNursing Service Related ProvidersTechnician
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
E1303796OtherNREMT
E1303796OtherNREMT