Provider Demographics
NPI:1679711956
Name:BRADLEY, SHELDON SCOTT (CRNP)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:SCOTT
Last Name:BRADLEY
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FRENCHMENS KY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-8621
Mailing Address - Country:US
Mailing Address - Phone:251-599-0353
Mailing Address - Fax:
Practice Address - Street 1:ENVISION HEALTHCARE
Practice Address - Street 2:1525 W. CYPRESS CREEK RD
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:615-787-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01276700363LF0000X
KS179177363LF0000X
AL1-094533363LF0000X
NYF347239-01363LF0000X
MT179177363LF0000X
NV888263363LF0000X
VA0024174418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1871318428OtherCASH BASE DTELEHEALTH PRACTICE