MRS. MICHELLE A BRADY F.N.P. NPI 1396735379

NPI Information

NPI: 1396735379
Provider Name: MRS. MICHELLE A BRADY, F.N.P.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
1200 W STATE ST
ROCKFORD, IL
ZIP 61102
Phone: (815) 490-1600
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MRS. Michelle A Brady, F.N.P. is a family nurse practitioner in Rockford, IL. MRS. Michelle A Brady, F.N.P. NPI is 1396735379. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1200 W STATE ST
ROCKFORD, IL
ZIP 61102-112
Phone: (815) 490-1600
Fax: (815) 490-1625

The enumeration date for this NPI number is 10/21/2005 and was last updated on 12/10/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209003868	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	309001823	OTHER	ILLINOIS	IL STATE CTL SUB LICENSE
2	209003868	MEDICAID	ILLINOIS
3	209003868	OTHER	ILLINOIS	IL STATE LICENSE
4	MB1190759	OTHER	ILLINOIS	DEA NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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