Melinda Brady, RN
Individual provider Active NPI Registered Nurse · Waterloo, IA
NPI 1396154688 · NPPES record last updated Aug 12, 2014
Key facts
- NPI
- 1396154688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 136311 (IA)
- Practice address
- 3251 W 9TH St
Waterloo, IA 50702-5310 - Phone
- (319) 234-2893
- Fax
- (319) 234-0354
- NPI assigned
- Aug 12, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136311 | IA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black Hawk-Grundy Mental Health Center Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 136311 | IA | Yes |
Addresses
Primary practice location
3251 W 9TH St
Waterloo, IA 50702-5310
Mailing address
3251 W 9TH St
Waterloo, IA 50702-5310
Phone (319) 234-2893
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0074435 | Medicaid | IA |
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.