Provider Demographics
NPI:1316287865
Name:NUNLEY, BRADLEY JAMES (AS)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:JAMES
Last Name:NUNLEY
Suffix:
Gender:M
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 ENTERPRISE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5751
Mailing Address - Country:US
Mailing Address - Phone:434-385-0000
Mailing Address - Fax:434-385-0006
Practice Address - Street 1:1511 ENTERPRISE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5751
Practice Address - Country:US
Practice Address - Phone:434-385-0000
Practice Address - Fax:434-385-0006
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101001537237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist