Provider Demographics
NPI:1821756032
Name:GRADY, NORA MARY (MSN, RN, CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:MARY
Last Name:GRADY
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Gender:F
Credentials:MSN, RN, CPNP-PC
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Mailing Address - Street 1:11315 PEMBROOKE SQ STE 110
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4806
Mailing Address - Country:US
Mailing Address - Phone:301-645-6165
Mailing Address - Fax:
Practice Address - Street 1:9121 N MILITARY TRL STE 102
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5985
Practice Address - Country:US
Practice Address - Phone:561-619-2460
Practice Address - Fax:844-886-3192
Is Sole Proprietor?:No
Enumeration Date:2021-12-05
Last Update Date:2023-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR251702363LP0200X
FLAPRN11021949363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics