| Ms Gwendolyn Bradley, | |
|
294 Kings Ridge Blvd, O Fallon, IL 62269-6330 | |
| (618) 975-3781 | |
| Not Available |
| Full Name | Ms Gwendolyn Bradley |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 294 Kings Ridge Blvd, O Fallon, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578005955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 043049025 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Gwendolyn Bradley, 1811 San Ricardo Dr, Saint Louis, MO 63138-1942 Ph: (314) 306-4934 | Ms Gwendolyn Bradley, 294 Kings Ridge Blvd, O Fallon, IL 62269-6330 Ph: (618) 975-3781 |
Teresa Harris, Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 830 Deer Creek Rd, O Fallon, IL 62269 Phone: 314-574-8314 |
Amillia Polk, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 810 White Oak Dr Apt 5, O Fallon, IL 62269 Phone: 314-665-5308 |