Healthcare Provider Details

I. General information

NPI: 1730318411
Provider Name (Legal Business Name): MERRILYN A BRADY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERRILYN A MAURER RN

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 16TH ST STE 100
BAKERSFIELD CA
93301-3417
US

IV. Provider business mailing address

1691 THE ALAMEDA
SAN JOSE CA
95126-2203
US

V. Phone/Fax

Practice location:
  • Phone: 661-634-1000
  • Fax:
Mailing address:
  • Phone: 408-795-3619
  • Fax: 408-287-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number166553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: