LAURA KAY BRODERICK NPI 1811132475

NPI Information

NPI: 1811132475
Provider Name: LAURA KAY BRODERICK
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
1755 N BARKER RD
BROOKFIELD, WI
ZIP 53045
Phone: (262) 821-3939
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Laura Kay Broderick is a specialist in Brookfield, WI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Laura Kay Broderick NPI is 1811132475. 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:

1755 N BARKER RD
BROOKFIELD, WI
ZIP 53045-801
Phone: (262) 821-3939

The enumeration date for this NPI number is 12/11/2008 and was last updated on 12/11/2008.

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	174400000X	Specialist		722026	WISCONSIN	Yes

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
1	722026	OTHER	WISCONSIN	STATE LICENSE
2	40649500	MEDICAID	WISCONSIN

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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