Healthcare Provider Details
I. General information
NPI: 1891995379
Provider Name (Legal Business Name): ANDREA LEIGH BRADEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/23/2007
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US
IV. Provider business mailing address
265 BROOKVIEW CENTRE WAY STE 400
KNOXVILLE TN
37919-4052
US
V. Phone/Fax
- Phone: 404-605-4177
- Fax:
- Phone: 800-342-2898
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 049800 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 074888 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: