Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 141479 | NC |
N | 207V00000X | Obstetrician & Gynecologist | 55698 | WI |
Y | 207VX0000X | Obstetrician | 036.143327 | IL |
NPI | 1124225073 |
---|---|
Provider Name | Sarah Bradley |
First Address | Milwaukee, WI 53278-8866 |
Second Address | Rockford, IL 61104-2315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 15/04/2021 |