Individual
MRS. KELLY LYNNE BROEKHOF
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
BLDG 2104 MASSEY AVE, NAVAL STATION MAYPORT, JACKSONVILLE, FL 32222
(904) 270-4293
Mailing address
644 ORISKANY ST, JACKSONVILLE, FL 32227-1712
(904) 372-9141
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN 45281
HI
Other
Enumeration date
06/16/2006
Last updated
07/08/2007
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