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General NPI Number Information
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NPI Number | 1144202383
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Entity Type | Individual
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Provider Name | SIMONE H BRADY CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 6250 OLD DOBBIN LN
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City | COLUMBIA
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State | MD
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Zip | 21045-5816
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Country | US
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Telephone | 410-730-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 309 EAGLE BAY LN BAY
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-8377
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Country | US
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Telephone | 443-789-1818
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Fax | 850-534-4171
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 3268080889
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R115117
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9483357
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License Number State | FL
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