Koren H Bradshaw, MS, CLC
Nutritionist in Fairfield, Connecticut
1205308012- Practice location
- 32 Ermine St, Fairfield, CT 06824-5109
- Phone
- 617-827-5223
- Fax
- —
- Last updated
- December 19, 2018
Koren H. Bradshaw is a Nutritionist based in Fairfield, CT. Koren H. Bradshaw practices in Fairfield, CT and has the professional credentials of MS, CLC. The NPI Number for Koren H. Bradshaw is 1205308012. The current practice location address for Koren H. Bradshaw is 32 Ermine St, Fairfield, CT 06824-5109 and can be reached out via phone at 617-827-5223.
Provider Profile Details
- NPI Number
- 1205308012
- Provider Name
- Koren H. Bradshaw
- Credential
- MS, CLC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 32 Ermine St, Fairfield, CT 06824-5109
- Phone Number
- 617-827-5223
- Primary Taxonomy
- Nutritionist · 133N00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- December 19, 2018
- Last Update Date
- December 19, 2018
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 32 Ermine St
Fairfield, CT 06824-5109 - City
- Fairfield
- State
- Connecticut
- Zip
- 06824-5109
- Phone Number
- 617-827-5223
Provider Business Mailing Address Details
- Address
- 32 Ermine St
Fairfield, CT 06824-5109 - City
- Fairfield
- State
- CT
- Zip
- 06824-5109
- Phone Number
- 617-827-5223
License Information
- Taxonomy (1)
- Nutritionist, Nutrition, Education · 133NN1002X
- Taxonomy (2)
- Lactation Consultant, Non-RN · 174N00000X
- Taxonomy (3)
- Nutritionist · 133N00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nutritionists near Fairfield, CT
View all Nutritionists in Fairfield →Frequently Asked Questions
What is the NPI number of Koren H Bradshaw, MS, CLC?
The NPI number of Koren H Bradshaw, MS, CLC is 1205308012. It was assigned on December 19, 2018 and is currently active in the NPPES registry.
What is the specialty of Koren H Bradshaw, MS, CLC?
Koren H Bradshaw, MS, CLC is registered under the primary taxonomy Nutritionist (code 133N00000X).
Where does Koren H Bradshaw, MS, CLC practice?
The practice location is 32 Ermine St, Fairfield, CT 06824-5109. The office can be reached at 617-827-5223 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1205308012 directly on the NPPES registry website.