Provider Demographics
NPI:1285462416
Name:BRADLEY-VAN ORMAN, MARGARET ELIZABETH (RN699541)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:BRADLEY-VAN ORMAN
Suffix:
Gender:F
Credentials:RN699541
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 STAGHORN LN
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-8574
Mailing Address - Country:US
Mailing Address - Phone:570-350-5944
Mailing Address - Fax:
Practice Address - Street 1:1004 STAGHORN LN
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-8574
Practice Address - Country:US
Practice Address - Phone:570-350-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN699541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse