Individual
SARAH A BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, NP-C
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 10, FORT WAYNE, IN 46845-1733
(260) 425-6800
(260) 425-6845
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003304A
IN
363LF0000X
Family Nurse Practitioner
71003304A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000671907
BC/BS
IN
05
—
200993110D
—
IN
01
—
P00841050
RAILROAD MEDICARE
—
Enumeration date
06/27/2010
Last updated
10/20/2022
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