Provider Demographics
NPI:1043784853
Name:BRADY, JEANNE MIRANDA GAPAC (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:MIRANDA GAPAC
Last Name:BRADY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15103 YOSEMITE WAY
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-6037
Mailing Address - Country:US
Mailing Address - Phone:408-410-3171
Mailing Address - Fax:831-753-5105
Practice Address - Street 1:420 EAST ROMIE LANE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-759-3263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy