Jolliffee Tanyareah Braddy, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN150985 Issued in GA

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(912) 450-1574

NPI assigned

Jun 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jolliffee Tanyareah Braddy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Senior Psych Solutions Corp

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1225078629
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1699096255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MCQUEEN DR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222240",
            "telephone_number": "912-450-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "912-450-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDY",
        "first_name": "JOLLIFFEE",
        "middle_name": "TANYAREAH",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN150985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLLIFFEE",
            "last_name": "BRADDY",
            "middle_name": "TANYAREAH",
            "prefix": "MS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie A Bowker, L.M.F.T.
• Helen Claire Boy, LICSW LADC
• Jody Boyd, AT
• Sylvia B Boye-Doe, DNP, CNP
• Kaitlyn Nicole Bozek
• Kimberly Kay Brands, MS, FNP-C
• David Brandsrud, PMHNP-BC, CNP
• Holly Lynn Ugomma Brannan, PSYD
• Kristin L Brastad, PT
• Renata Anne Braudy, PT

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.