Healthcare Provider Details

I. General information

NPI: 1720571987
Provider Name (Legal Business Name): MEAGAN LEE BRADY DNP, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6335 HOSPITAL PKWY STE 200
JOHNS CREEK GA
30097-1550
US

IV. Provider business mailing address

605 MARTHA WAY
ALPHARETTA GA
30005-5507
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4892
  • Fax: 404-778-8241
Mailing address:
  • Phone: 440-773-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN276875
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: