Provider Demographics
NPI:1609856954
Name:BRADY, JOEL EDWARD (NCCPA)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:EDWARD
Last Name:BRADY
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Gender:M
Credentials:NCCPA
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Mailing Address - Street 1:15301 WARREN SHINGLE RD
Mailing Address - Street 2:
Mailing Address - City:BEALE AFB
Mailing Address - State:CA
Mailing Address - Zip Code:95903-1907
Mailing Address - Country:US
Mailing Address - Phone:530-634-4750
Mailing Address - Fax:530-634-4844
Practice Address - Street 1:15301 WARREN SHINGLE RD
Practice Address - Street 2:
Practice Address - City:BEALE AFB
Practice Address - State:CA
Practice Address - Zip Code:95903-1907
Practice Address - Country:US
Practice Address - Phone:530-634-4750
Practice Address - Fax:530-634-4844
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant