Provider Demographics
NPI:1679149223
Name:BRADFORD, MELANIE ALDRIDGE (FNP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ALDRIDGE
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 TWEETSIE LN W
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-6619
Mailing Address - Country:US
Mailing Address - Phone:828-773-9273
Mailing Address - Fax:
Practice Address - Street 1:321 MULBERRY ST SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5720
Practice Address - Country:US
Practice Address - Phone:828-757-5504
Practice Address - Fax:828-757-5225
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCBRAD-YM4R5363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily