Provider Demographics
NPI:1932811825
Name:BRADLEY, COLLEEN R (PA-C)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:R
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:1401 TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1815
Mailing Address - Country:US
Mailing Address - Phone:610-757-7655
Mailing Address - Fax:
Practice Address - Street 1:127 W STREET RD STE 101
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1698
Practice Address - Country:US
Practice Address - Phone:610-444-1212
Practice Address - Fax:610-444-3633
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2023-01-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant