Provider Demographics
NPI:1306061924
Name:BRADLEY, CHARLENE F (RN)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:F
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ROPE FERRY RD # 6143
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1404
Mailing Address - Country:US
Mailing Address - Phone:603-646-9464
Mailing Address - Fax:603-646-9450
Practice Address - Street 1:7 ROPE FERRY RD # 6143
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1404
Practice Address - Country:US
Practice Address - Phone:603-646-9464
Practice Address - Fax:603-646-9450
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH015238-21163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator