Provider Demographics
NPI:1861268260
Name:BRADY, VICTORIA TAYLOR (CRNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:TAYLOR
Last Name:BRADY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:SKIPPACK
Mailing Address - State:PA
Mailing Address - Zip Code:19474-0326
Mailing Address - Country:US
Mailing Address - Phone:215-692-3988
Mailing Address - Fax:
Practice Address - Street 1:711 LAWN AVE STE 5
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1583
Practice Address - Country:US
Practice Address - Phone:215-257-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028081363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics