Individual
MARY ANGELA BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7945 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1762
(901) 683-0055
(901) 685-2969
Mailing address
7714 POPLAR AVE STE 200, ATTN: CREDENTIALING, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 922-6722
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14043
TN
363LF0000X
Family Nurse Practitioner
14043
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06376837
—
MS
05
—
1513461
—
TN
Enumeration date
03/24/2009
Last updated
04/03/2017
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