Provider Demographics
NPI:1235500489
Name:BRADY, SHAWN ADAM (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:ADAM
Last Name:BRADY
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:510 HOSPITAL DR STE 260
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5027
Mailing Address - Country:US
Mailing Address - Phone:615-859-9902
Mailing Address - Fax:615-859-9906
Practice Address - Street 1:510 HOSPITAL DR STE 260
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5027
Practice Address - Country:US
Practice Address - Phone:615-859-9902
Practice Address - Fax:615-859-9906
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20556363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health