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Individual
JACQUELINE B. BROADWAY
Active
Individual
JACQUELINE B. BROADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
675246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154863801
—
TX
01
—
8N2953
BCBS
TX
Enumeration date
11/01/2006
Last updated
10/27/2010
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