Individual
MS. JOLLIFFEE TANYAREAH BRADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(912) 450-1574
Mailing address
210 MCQUEEN DR, POOLER, GA 31322-2240
(912) 450-1574
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN150985
GA
Other
Enumeration date
06/17/2010
Last updated
09/18/2020
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