Individual
SHIRLEY A BRADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2920 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-5924
(618) 244-6544
(618) 244-6577
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2436
(618) 724-2571
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043068030
IL
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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