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General NPI Number Information
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NPI Number | 1861001745
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Entity Type | Individual
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Provider Name | JESSICA MICHELLE MCCREE BRADDY CNA
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Gender | Female
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 10151 DEERWOOD PARK BLVD STE 250
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0566
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Country | US
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Telephone | 904-577-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 10151 DEERWOOD PARK BLVD STE 250 SUITE 250 ; BLD 200
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0566
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Country | US
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Telephone | 904-577-2440
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA468355
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CN0030001488
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License Number State | GA
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