Provider Demographics
NPI:1578080909
Name:BRADY, ELLEN FRANCES (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:FRANCES
Last Name:BRADY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 WESTCOTT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1751
Mailing Address - Country:US
Mailing Address - Phone:401-241-5578
Mailing Address - Fax:401-398-8765
Practice Address - Street 1:400 PUTNAM PIKE
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917
Practice Address - Country:US
Practice Address - Phone:401-757-6160
Practice Address - Fax:401-349-0840
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily