Provider Demographics
NPI:1730318411
Name:BRADY, MERRILYN A (RN)
Entity Type:Individual
Prefix:MRS
First Name:MERRILYN
Middle Name:A
Last Name:BRADY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MERRILYN
Other - Middle Name:A
Other - Last Name:MAURER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-795-3619
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:2535 16TH ST
Practice Address - Street 2:STE 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3417
Practice Address - Country:US
Practice Address - Phone:661-634-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA166553163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse