Provider Demographics
NPI:1497485593
Name:TRUE, BRADY SCOTT
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:SCOTT
Last Name:TRUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 587
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-0587
Mailing Address - Country:US
Mailing Address - Phone:785-738-2246
Mailing Address - Fax:785-738-2506
Practice Address - Street 1:1005 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-1215
Practice Address - Country:US
Practice Address - Phone:785-738-2246
Practice Address - Fax:785-738-2560
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS135485163W00000X
KS81317363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse