Provider Demographics
NPI:1336424811
Name:O'GRADY, BERNADETTE A (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:A
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:A
Other - Last Name:BARDALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2424 N WYATT DR STE 260
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6118
Mailing Address - Country:US
Mailing Address - Phone:520-795-0608
Mailing Address - Fax:520-795-0354
Practice Address - Street 1:2424 N WYATT DR STE 260
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6118
Practice Address - Country:US
Practice Address - Phone:520-392-7500
Practice Address - Fax:520-323-4350
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008483363LW0102X
AZAP11350363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health