Basic Information
| Provider Information | |||||||||
| NPI: | 1174010912 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIGNS | ||||||||
| FirstName: | BRADY | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 COVEY DR | ||||||||
| Address2: | |||||||||
| City: | YARMOUTH PORT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026752255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084235875 | ||||||||
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| Practice Location | |||||||||
| Address1: | 27 PARK ST | ||||||||
| Address2: | |||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026015203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088625000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2018 | ||||||||
| LastUpdateDate: | 10/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | RN275920 | MA | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 367500000X | RN275920 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.