Individual
MRS. MARY ANN BRODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
106 E MAIN ST, SPRING ARBOR, MI 49283-9701
(517) 750-6352
(517) 750-6625
Mailing address
106 E MAIN ST, SPRING ARBOR, MI 49283-9701
(517) 740-9869
(517) 750-6625
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704119440
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470411940
LICENSE
MI
01
—
83 20029
PHP
MI
Enumeration date
09/26/2006
Last updated
02/16/2016
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