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Individual
TRENT MICHAEL BROADUS
Active
Individual
TRENT MICHAEL BROADUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95006008
CA
363L00000X
Nurse Practitioner
ARNP9353539
FL
363LA2100X
Acute Care Nurse Practitioner
570228
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95006008
CA NP LICENSE
CA
01
—
ARNP9353539
FLA MEDICAL LICENSE
FL
Enumeration date
09/21/2011
Last updated
03/17/2018
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