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General NPI Number Information
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NPI Number | 1205028974
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Entity Type | Individual
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Provider Name | MARKEETA M BRADY RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 144 DAWN CIR
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City | BRUNSWICK
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State | GA
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Zip | 31523-6405
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Country | US
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Telephone | 912-554-8275
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3087
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City | BRUNSWICK
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State | GA
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Zip | 31521-3087
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Country | US
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Telephone | 912-554-8275
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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 | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | RN115500
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN115500
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN115500
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number | RN115500
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License Number State | GA
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