Individual
TAMIKA NICOLE BRADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 CLYBURN PL, AIKEN, SC 29801-4193
(803) 380-7000
(803) 642-6186
Mailing address
1000 CLYBURN PL, AIKEN, SC 29801-4193
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN095920
GA
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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