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General NPI Number Information
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NPI Number | 1154990109
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Entity Type | Individual
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Provider Name | LESLEE MARIE BRADY APRN
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 2600 WESTHALL LN
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City | MAITLAND
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State | FL
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Zip | 32751-7102
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Country | US
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Telephone | 407-200-2273
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Fax | 407-200-1353
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Provider Business Mailing Address
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Address Line | 4312 N 110TH TER
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City | KANSAS CITY
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State | KS
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Zip | 66109-3603
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Country | US
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Telephone | 773-332-7116
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-80347-121
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License Number State | KS
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