Individual
MARY LOUISE BRADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
911 LARAYNE LN, NORFOLK, NE 68701-0847
(402) 870-0343
Mailing address
911 LARAYNE LN, NORFOLK, NE 68701-0847
(402) 870-0343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
35322
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17809
LEAGUE OF HUMAN DIGNITY
NE
Enumeration date
05/23/2019
Last updated
05/23/2019
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