Individual
MR. BRADY PAUL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
13943 N . 91ST AVE BUILDING I, PEORIA, AZ 85381-3692
(623) 815-2690
(623) 815-2689
Mailing address
13943 N. 91ST AVE BUILDING I, PEORIA, AZ 85381-3692
(623) 815-2690
(623) 815-2689
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2677
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2677
—
AZ
05
—
736077
—
AZ
Enumeration date
09/13/2006
Last updated
02/17/2012
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