Provider Demographics
NPI:1336953884
Name:METZGER, BRADY LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:BRADY
Middle Name:LEE
Last Name:METZGER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2161
Mailing Address - Country:US
Mailing Address - Phone:712-460-0550
Mailing Address - Fax:
Practice Address - Street 1:26 BLUE RIDGE DR
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2161
Practice Address - Country:US
Practice Address - Phone:712-460-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN322731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily