Provider Demographics
NPI:1265606560
Name:BRADLEY, PATRICIA LYNN (RD MA CDE)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:RD MA CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:32060 LONG NECK RD
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-6228
Mailing Address - Country:US
Mailing Address - Phone:302-947-2500
Mailing Address - Fax:302-947-2909
Practice Address - Street 1:32060 LONGNECK ROAD
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966
Practice Address - Country:US
Practice Address - Phone:302-947-2500
Practice Address - Fax:302-947-2909
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic