Jason Derek Bradshaw
Nurse Practitioner - Family Medicine
1901 S 1st St
Temple
, Texas 76504-7451
Jason Derek Bradshaw
Nurse Practitioner - Family Medicine
1901 S 1st St
Temple
, Texas 76504-7451
(512) 635-2759
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Jason Derek Bradshaw
- 4006 Fountainwood Cir
- Georgetown, TX
- Zip : 78633-1911
- Phone : (512) 635-2759
Second Address
- Jason Derek Bradshaw
- 1901 S 1st St
- Temple, TX
- Zip : 76504-7451
- Phone : (254) 743-0714
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 687070 | TX |
National Provider Identifier
| NPI | 1003178450 |
|---|---|
| Provider Name | Jason Derek Bradshaw |
| First Address | Georgetown, TX 78633-1911 |
| Second Address | Temple, TX 76504-7451 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/06/2012 |
| Last Update Date | 12/06/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.