Provider Demographics
NPI:1861092546
Name:BRADFORD, AYSHEA JANAE (MSN, CRNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:AYSHEA
Middle Name:JANAE
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-BC
Other - Prefix:
Other - First Name:AYSHEA
Other - Middle Name:JANAE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19174
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35219-9174
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 SAINT VINCENTS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1601
Practice Address - Country:US
Practice Address - Phone:205-939-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-133451163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse