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MS. EDDIE RUTH BRADFORD FNP
NPI 1366599508
Nurse Practitioner - Family in Lula, MS

Active since January 03, 2007
777 ISLE OF CAPRI PKWY, LULA, MS 38644(662) 337-4554(662) 337-4564 Get Directions Write a Review

NPPES record last updated: September 4, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Eddie Ruth Bradford Fnp NPPES

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

MS. EDDIE RUTH BRADFORD FNP (NPI 1366599508) is an individual family provider in Lula, Mississippi, licensed in Mississippi (R659975) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1366599508
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. EDDIE RUTH BRADFORDCredential: FNP
Location Address777 ISLE OF CAPRI PKWYLula, MS 38644-9701
Mailing Address777 Isle Of Capri PkwyLula, MS 38644-9701 · (662) 337-4554 · Fax (662) 337-4564
Phone(662) 337-4554
Fax(662) 337-4564
Sole ProprietorNo
Enumeration DateJanuary 3, 2007
Last NPPES UpdateSeptember 4, 2019
✔ NPI 1366599508 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 MS · R659975
777 ISLE OF CAPRI PKWY, Lula, MS 38644
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Other Identifiers 2

Medicaid00119310MS
Medicaid191427758AR

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 Eddie Bradford's NPI number?

The NPI number for Eddie Bradford is 1366599508. It was assigned to this individual provider in the NPPES registry on January 3, 2007.

Where is Eddie Bradford located?

Eddie Bradford practices at 777 Isle Of Capri Pkwy, Lula, MS 38644. The listed phone number is (662) 337-4554.

What is Eddie Bradford'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 Eddie Bradford was last updated on September 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.