Individual
MADISON BROADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
195 W ILLINOIS AVE, SOUTHERN PINES, NC 28387-5808
(910) 692-2444
Mailing address
195 W ILLINOIS AVE, SOUTHERN PINES, NC 28387-5808
(910) 692-2444
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5018127
NC
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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