Clydena Jean Broughton FNP - C

NPI 1588979314 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1588979314
Gender Female
Enumeration Date 08/17/2010
Last Updated 12/17/2015
Entity Type Individual
Active Over 6 years ago
Practice Location
11 COURTNEY DR
CHARLESTON WV, 25304-2699, US
Phone (304) 925-8521
Fax (304) 925-8523
Business Location
11 COURTNEY DR
CHARLESTON WV, 25304-2699, US
Phone (304) 925-8521
Fax (304) 388-1721
Toxanomy
Taxonomy Code 363LF0000X
License State West Virginia
License Number APRN62736-NP-C
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According to our database, Clydena Jean Broughton FNP - C NPI is 1588979314, taxonomy code is 363LF0000X and license number is APRN62736-NP-C, license state is located at West Virginia. Clydena Jean Broughton FNP - C physically located at 11 Courtney Dr, Charleston WV, 25304-2699. NPI Number Clydena Jean Broughton FNP - C has the Individual type.

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1588979314 NPI number is provided on an as is basis without warranty of any kind. 1588979314 is maintained by the National Plan & Provider Enumeration System. The contents of Clydena Jean Broughton FNP - C are for informational purposes only.