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General NPI Number Information
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NPI Number | 1336424811
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Entity Type | Individual
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Provider Name | BERNADETTE A. O'GRADY WHNP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 2424 N WYATT DR STE 260
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City | TUCSON
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State | AZ
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Zip | 85712-6118
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Country | US
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Telephone | 520-392-7500
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Fax | 520-323-4350
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Provider Business Mailing Address
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Address Line | 2424 N WYATT DR STE 260
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City | TUCSON
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State | AZ
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Zip | 85712-6118
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Country | US
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Telephone | 520-795-0608
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Fax | 520-795-0354
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 209.008483
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP11350
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License Number State | AZ
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