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NPI Code Detail

MEDICARE: CHRISTINA SAMANTHA BRADY RN

MEDICARE: CHRISTINA SAMANTHA BRADY RN
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 Nurse2023041510MO
2163WM0705XMedical-Surgical Registered Nurse2023041510MO
3163WP0808XPsychiatric/Mental Health Registered Nurse2023041510MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12023041510OTHERMONURSINGLICENSE

General Provider Information

NPI Number : 1366398216
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA SAMANTHA BRADY RN
Provider Business Mailing Address
First Line : 3443 N BELLEFONTAINE AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64117-2411
Country : US
Telephone Number : 816-588-0551
Fax Number :
Provider Business Practice Location Address
First Line : 3600 30TH ST
Second Line :
City : DES MOINES
State : IA
Zip : 50310-5753
Country : US
Telephone Number : 515-388-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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