Healthcare Provider Details

I. General information

NPI: 1942465620
Provider Name (Legal Business Name): JEAN REIMER-BRADY RN, MSN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE BOX 0210
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

206 VALENCIA DR
MILLBRAE CA
94030-2857
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1247
  • Fax:
Mailing address:
  • Phone: 650-692-2069
  • Fax: 650-692-2069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number2192
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: