Provider Demographics
NPI:1447417449
Name:BRADY, BARBARA (CNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:BAINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:2020 S SOLANO DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5416
Mailing Address - Country:US
Mailing Address - Phone:575-523-4880
Mailing Address - Fax:575-523-1796
Practice Address - Street 1:2020 S SOLANO DR
Practice Address - Street 2:SUITE C
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5416
Practice Address - Country:US
Practice Address - Phone:575-523-4880
Practice Address - Fax:575-523-1796
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR30227363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner