Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 0435805 | KS |
Y | 207Q00000X | Family Doctor | 0435805 | KS |
N | 207Q00000X | Family Doctor | 2012011120 | MO |
NPI | 1134362015 |
---|---|
Provider Name | Dr. Sarah Evelyn Bradshaw |
First Address | Pittsburg, KS 66762-1832 |
Second Address | Iola, KS 66749-1677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2009 |
Last Update Date | 23/04/2021 |