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General NPI Number Information
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NPI Number | 1104592625
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Entity Type | Individual
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Provider Name | HOLLY MARIE JOLAN BRADY DNP, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 1626 LOCUST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6305
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Country | US
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Telephone | 302-265-0020
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Fax | 302-587-8928
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Provider Business Mailing Address
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Address Line | PO BOX 4737
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City | PHILADELPHIA
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State | PA
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Zip | 19134-0137
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Country | US
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Telephone | 302-265-0020
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Fax | 302-587-8928
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11014903
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License Number State | FL
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