Provider Demographics
NPI:1275124067
Name:BRADY, KAYLA NICOLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:NICOLE
Last Name:BRADY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:NICOLE
Other - Last Name:SANTANELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:737 DANIELSON PIKE
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1570
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2401
Practice Address - Country:US
Practice Address - Phone:401-274-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily