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NPI Code Detail

MEDICARE: KAREN M BRADY NURSE PRACTITIONER

MEDICARE: KAREN M BRADY NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN 199738OH
2363LA2200XAdult Health Nurse PractitionerCOA. 09197-NPOH

General Provider Information

NPI Number : 1154549418
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN M BRADY NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-286-3543
Fax Number :
Provider Business Practice Location Address
First Line : 11000 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1714
Country : US
Telephone Number : 216-844-1000
Fax Number : 216-201-7657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 01/08/2021

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