Provider Demographics
NPI:1598122475
Name:BRADY, CATHERINE (PA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:BRADY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:382 S ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-3094
Practice Address - Country:US
Practice Address - Phone:404-257-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0006064363AM0700X
GA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical