Michelle A Brady, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209003868 Issued in IL

Practice address

1200 W State St
Rockford, IL 61102-2112

Phone

(815) 490-1600

Fax

(815) 490-1625

NPI assigned

Oct 21, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Miss Michelle A Yoe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396735379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209003868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE CTL SUB LICENSE",
            "identifier": "309001823",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209003868",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LICENSE",
            "identifier": "209003868",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "YOE",
            "middle_name": "A",
            "prefix": "MISS",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsay Ann Brackney, MD
• Braden Partners LP (Pacific Pulmonary Services)
• Darla Jo Bradle, APN, CNS-BC
• Sasha Kate Bradle, PHARMD
• Sarah Bradley, M.D.
• Kathryn E Bramble, PA-C
• Cynthia Antoinett Brander, PSY.D.
• Olesya Brandis, MD
• Patricia Brandon, NP
• Gary W Brankin, D.D.S., M.S.

• Family Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.