NICOLE BRODERSON LLC NPI 1932473741

NPI Information

NPI: 1932473741
Provider Name: NICOLE BRODERSON LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1421 LUISA ST
SUITE N
SANTA FE, NM
ZIP 87505
Phone: (505) 428-0072
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NICOLE BRODERSON LLC is a mental health counselor in Santa Fe, NM. NICOLE BRODERSON LLC NPI is 1932473741. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1421 LUISA ST
SUITE N
SANTA FE, NM
ZIP 87505-073
Phone: (505) 428-0072
Fax: (888) 256-1158

The provider's authorized official is Nicole R Broderson .
The authorized official title is Nurse Practitioner and has the following contact phone number (505) 428-0072.

The enumeration date for this NPI number is 2/27/2012 and was last updated on 7/31/2013.

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	101YM0800X	Counselor	Mental Health	MB2485490	NEW MEXICO	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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