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General NPI Number Information
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NPI Number | 1215650114
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Entity Type | Individual
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Provider Name | LAURA LYNN BRADEN RN
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 2169 LAWRENCEVILLE HWY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7710
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Country | US
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Telephone | 770-676-5878
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 MEDICAL CENTER BLVD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7694
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Country | US
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Telephone | 678-312-1000
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN283208
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | RN283208
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License Number State | GA
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