| Doctor Name: | MARY BRADY |
| NPI Number: | 1417385295 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN195811 |
| Business Practice Address: | 395 W Parker St Ste 4 Baxley, GA - 315130660 |
| Business Phone Number: | 9127055656 |
| Business Fax Number: | 9127065652 |
| Mailing Address: | 215 N Coleman St, SWAINSBORO |
| State: | GA |
| Postal Code: | 304013530 |
| Phone Number: | 4782372638 |
| Fax Number: | 4782379138 |
| NPI Enumeration Date: | 10/14/2013 |
| NPI Last Update Date: | 10/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN195811 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |