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KATRINA ELIZABETH BRADLEY PHARMD
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1861979569
Individual Registrant: KATRINA ELIZABETH BRADLEY PHARMD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2833 BELLA VISTA WAY BELLA VISTA, AR 72714-3709 US
Tel: 479-876-2153 Fax: 479-876-2184
Tel: 479-876-2153 Fax: 479-876-2184
Contact information for business:
2171 BUCK CV PEA RIDGE, AR 72751-5000 US
Tel: 479-426-0614 Fax: --
Tel: 479-426-0614 Fax: --
Registration Information:
NPI: 1861979569
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | AR | PD14611 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| PHARMACIST LICENSE | PD14611 | AR | 01 |
