Individual
MRS. SELINA LOUISE BROADAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(888) 226-4343
Mailing address
848 ADAMS AVE, MEMPHIS, TN 38103-2816
(901) 661-3719
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
31660
TN
Other
Enumeration date
05/16/2022
Last updated
02/07/2024
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