BROADWAY FAMILY CLINIC LLC NPI 1427566694

NPI Information

NPI: 1427566694
Provider Name: BROADWAY FAMILY CLINIC LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
612 STATE HIGHWAY 25 S
BLOOMFIELD, MO
ZIP 63825
Phone: (573) 803-3995
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BROADWAY FAMILY CLINIC LLC is a family nurse practitioner in Bloomfield, MO. BROADWAY FAMILY CLINIC LLC NPI is 1427566694. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

612 STATE HIGHWAY 25 S
BLOOMFIELD, MO
ZIP 63825-566
Phone: (573) 803-3995
Fax: (573) 803-5222

The provider's authorized official is Melissa Jarrell .
The authorized official title is Office/billing Supervisor and has the following contact phone number (573) 568-7377.

The enumeration date for this NPI number is 1/22/2018 and was last updated on 8/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	126560	MISSOURI	No
2	363LF0000X	Nurse Practitioner	Family	2014044250	MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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