Mr Lee W Bradshaw, APRN | |
3903 Harrison Blvd, #300, Ogden, UT 84403-8440 | |
(801) 387-4930 | |
(801) 387-9470 |
Full Name | Mr Lee W Bradshaw |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 43 Years |
Location | 3903 Harrison Blvd, Ogden, Utah |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588660773 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
364SP0808X | Clinical Nurse Specialist - Psychiatric/mental Health | 6242996-4405 (Utah) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Intermountain Healthcare Services, Inc | 1850209420 | 3228 |
Entity Name | Ihc Health Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
Entity Name | Ihc Health Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
Mailing Address | Practice Location Address |
---|---|
Mr Lee W Bradshaw, APRN Po Box 27128, Salt Lake City, UT 84127-0128 Ph: (801) 387-5600 | Mr Lee W Bradshaw, APRN 3903 Harrison Blvd, #300, Ogden, UT 84403-8440 Ph: (801) 387-4930 |
Mary Morgal, APRN, CCNS Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 4401 Harrison Blvd, Ogden, UT 84403 Phone: 801-387-2254 Fax: 801-387-2243 | |
Mrs. Grace Belliston, APRN Clinical Nurse Specialist Medicare: Medicare Enrolled Practice Location: 982 Chambers St, Ogden, UT 84403 Phone: 801-479-4105 | |
Jacy Winner, RN Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 477 23rd St, Ogden, UT 84401 Phone: 801-399-7240 | |
Paula Jean Cooper, APRN Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 4401 Harrison Blvd, Ste 1885, Ogden, UT 84403 Phone: 801-387-4870 Fax: 801-475-1621 |