Provider Demographics
NPI:1124252473
Name:BRADLEY, ROBYN ANNETTE (RT(R)(M))
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:ANNETTE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:RT(R)(M)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 BRIDGESIDE DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2906
Mailing Address - Country:US
Mailing Address - Phone:859-881-1588
Mailing Address - Fax:859-881-9703
Practice Address - Street 1:100 BRIDGESIDE DR
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2906
Practice Address - Country:US
Practice Address - Phone:859-881-1588
Practice Address - Fax:859-881-9703
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography