Individual
MS. NYKEBA S BRADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1061 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5641
(912) 435-6633
(912) 435-6633
Mailing address
1061 HARMON AVE STE 1D03, FORT STEWART, GA 31314-5641
(912) 435-6633
(912) 435-6633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6774
GA
363A00000X
Physician Assistant
PA00548
RI
Other
Enumeration date
04/18/2007
Last updated
03/04/2014
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