Provider Demographics
NPI:1356401020
Name:BRADY, DENISE A (APRN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:BRADY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-778-1620
Mailing Address - Fax:603-772-8015
Practice Address - Street 1:118 PORTSMOUTH AVE BLDG D
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2487
Practice Address - Country:US
Practice Address - Phone:603-778-1620
Practice Address - Fax:603-772-8015
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043995-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076459Medicaid
NH3076459Medicaid
30616YMedicare UPIN
NH3076459Medicaid