Individual
NICOLE A BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
N9642 COUNTY TRUNK N, APPLETON, WI 54915
(920) 628-1500
Mailing address
N9642 COUNTY TRUNK N, APPLETON, WI 54915
(920) 628-1500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43676
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34145600
—
WI
Enumeration date
12/11/2006
Last updated
08/28/2008
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