Individual
MRS. STACY ANN BROUGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
W161N9517 BLACKFOOT DR, MENOMONEE FALLS, WI 53051-1565
(414) 795-4257
Mailing address
W161N9517 BLACKFOOT DR, MENOMONEE FALLS, WI 53051-1565
(414) 795-4257
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
163175
WI
Other
Enumeration date
05/02/2021
Last updated
05/02/2021
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