Provider Demographics
NPI:1013347707
Name:BURGE, BRADY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BRADY
Middle Name:
Last Name:BURGE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:BRADY
Other - Middle Name:
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3280 DAUPHIN ST
Mailing Address - Street 2:BLDG A 101
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4060
Mailing Address - Country:US
Mailing Address - Phone:251-450-3700
Mailing Address - Fax:251-545-3010
Practice Address - Street 1:3280 DAUPHIN ST
Practice Address - Street 2:BLDG A 101
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4060
Practice Address - Country:US
Practice Address - Phone:251-662-3737
Practice Address - Fax:251-545-3010
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-119026363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care