Provider Demographics
NPI:1386704252
Name:BRADFORD, NANCY KAY (MA, LMPH)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KAY
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:MA, LMPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:1023 10TH AVENUE
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162
Mailing Address - Country:US
Mailing Address - Phone:308-254-0737
Mailing Address - Fax:308-254-6375
Practice Address - Street 1:1023 10TH AVENUE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162
Practice Address - Country:US
Practice Address - Phone:308-254-0737
Practice Address - Fax:308-254-6375
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1149101YP2500X
NE1999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
12604OtherMIDLANDS CHOICE
NE12604OtherCIGNA
412059215002OtherMUTUAL OF OMAHA
85008OtherB CROSS BLUE SHIELD
NE151493OtherMID AMERICA BENEFITS
NE412059215002OtherCOVENTRY
NE12604OtherCIGNA BEHAVIORAL HEALTH
NE12604OtherAETNA
NE$$$$$$$$$26OtherMAGELLAN BEHAVIORAL HEALTH SERVICES
85008OtherB CROSS BLUE SHIELD
NE151493OtherMID AMERICA BENEFITS
NE$$$$$$$$$26Medicaid