Provider Demographics
NPI:1861701849
Name:BRADY, DONNA CIPRIANO (RN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:CIPRIANO
Last Name:BRADY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 FORT HILL PARK
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13830
Mailing Address - Country:US
Mailing Address - Phone:607-843-7185
Mailing Address - Fax:607-843-3241
Practice Address - Street 1:12 FORT HILL PK
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NY
Practice Address - Zip Code:13830-0192
Practice Address - Country:US
Practice Address - Phone:607-843-7185
Practice Address - Fax:607-843-3241
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY328332-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool