Individual
TERESA BRADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2 SHIRCLIFF WAY, SUITE 900, JACKSONVILLE, FL 32204-4753
(904) 381-9651
Mailing address
1001 N MARTEL AVE, WEST HOLLYWOOD, CA 90046-6611
(323) 436-5019
(323) 337-9142
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9206359
FL
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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