Ms Eddie Ruth Bradford, FNP is a
Nurse Practitioner - Family based in Lula, Mississippi. Ms Eddie Ruth Bradford is licensed to practice in Mississippi (license number R659975) and her current practice location is
777 Isle Of Capri Pkwy, Lula, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(662) 337-4554.
NPI number for Ms Eddie Ruth Bradford is 1366599508 and her current mailing address is 777 Isle Of Capri Pkwy, Lula, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366599508.
Provider's Profile
| Full Name | Ms Eddie Ruth Bradford |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | 777 Isle Of Capri Pkwy, Lula, Mississippi |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1366599508
- Provider Enumeration Date: 01/03/2007
- Last Update Date: 09/04/2019
Medical Identifiers
Medical identifiers for Ms Eddie Ruth Bradford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366599508 | NPI | - | NPPES |
| 191427758 | Medicaid | AR | |
| 00119310 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | R659975 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Eddie Ruth Bradford is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Eddie Ruth Bradford, FNP
777 Isle Of Capri Pkwy,
Lula, MS 38644-9701
Ph: (662) 337-4554 | Ms Eddie Ruth Bradford, FNP
777 Isle Of Capri Pkwy,
Lula, MS 38644-9701
Ph: (662) 337-4554 |
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