Individual
NICOLE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA, ATC
Contact information
Practice address
46 BARRA RD STE 103, BIDDEFORD, ME 04005-9461
(207) 283-1126
(207) 294-3544
Mailing address
46 BARRA RD STE 103, BIDDEFORD, ME 04005-9461
(207) 283-1126
(207) 294-3544
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT805
ME
363A00000X
Physician Assistant
PA2817
ME
363AS0400X
Surgical Physician Assistant
Primary
PA2817
ME
Other
Enumeration date
02/28/2018
Last updated
03/05/2025
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