DEBORAH ANN BROADLEY NP NPI 1558531996

NPI Information

  • NPI: 1558531996
  • Provider Name: DEBORAH ANN BROADLEY, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 30 JORDAN LN
    WETHERSFIELD, CT
    ZIP 06109
  • Phone: (860) 263-0253

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NPI Details

Deborah Ann Broadley, NP is a family nurse practitioner in Wethersfield, CT. Deborah Ann Broadley, NP NPI is 1558531996. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

30 JORDAN LN
WETHERSFIELD, CT
ZIP 06109-278
Phone: (860) 263-0253
Fax: (860) 263-0262

The NPI 1558531996 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 2/29/2008 and was last updated on 12/2/2014.

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
1363LF0000XNurse PractitionerFamily3754CONNECTICUTYes
2363LP2300XNurse PractitionerPrimary Care003754CONNECTICUTNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D400072624MEDICARE PINCONNECTICUT
2008004412MEDICAIDCONNECTICUT

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: 11/21/2025

NPI Synchronization or Removal

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