Individual
MS. JACQUELYN DOLAN BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 899-9511
Mailing address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5798
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
312687
LA
363AS0400X
Surgical Physician Assistant
Primary
312687
LA
Other
Enumeration date
06/03/2019
Last updated
01/12/2024
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