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CRYSTAL BRADLEY FNP-C, FPA
NPI 1306447263
Nurse Practitioner - Family in Glen Carbon, IL

Active since November 05, 2020
4260 S STATE ROUTE 159 STE 1, GLEN CARBON, IL 62034(872) 713-7614 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 4, 2024, Nov 5, 2020 (2 updates tracked since 2020).

About Crystal Bradley Fnp-c, Fpa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL BRADLEY FNP-C, FPA (NPI 1306447263) is an individual family provider in Glen Carbon, Illinois, licensed in Illinois (277.003238) and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1306447263
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCRYSTAL BRADLEYCredential: FNP-C, FPA
Location Address4260 S STATE ROUTE 159 STE 1Glen Carbon, IL 62034-3201
Mailing Address4335 Wagner RdMarine, IL 62061-1253 · (314) 306-5239
Phone(872) 713-7614
Sole ProprietorYes
Enumeration DateNovember 5, 2020
Last NPPES UpdateSeptember 4, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2024
✔ NPI 1306447263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 277.003238
4260 S STATE ROUTE 159 STE 1, Glen Carbon, IL 62034
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Bradley's NPI number?

The NPI number for Crystal Bradley is 1306447263. It was assigned to this individual provider in the NPPES registry on November 5, 2020.

Where is Crystal Bradley located?

Crystal Bradley practices at 4260 S State Route 159 Ste 1, Glen Carbon, IL 62034. The listed phone number is (872) 713-7614.

What is Crystal Bradley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Crystal Bradley was last updated on September 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.