Individual
DIANA PATTON BROADDUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1710 EMERSON DR, MANSFIELD, OH 44904-1809
(419) 631-9259
Mailing address
1710 EMERSON DRIVE, MANSFIELD, OH 44904
(419) 631-9259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.313748
OH
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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