Provider Demographics
NPI:1598430852
Name:BRADEN, ERIN JO (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:JO
Last Name:BRADEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 WEST ST # 182
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-1442
Mailing Address - Country:US
Mailing Address - Phone:413-967-5562
Mailing Address - Fax:
Practice Address - Street 1:182 WEST ST
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1442
Practice Address - Country:US
Practice Address - Phone:413-967-5562
Practice Address - Fax:888-815-0947
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN260445363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care