Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 35193 | IA |
N | 207VG0400X | Gynecologist | 35193 | IA |
NPI | 1225022486 |
---|---|
Provider Name | Catherine S Bradley |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0294918 | (05) | IA |
34741 | WELLMARK BCBS (01) | IA |
G65138 | (02) |