Individual
DEWLENE BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNC,IBCLC
Contact information
Practice address
107 RAMBLING TRL, WEATHERFORD, TX 76087-6892
(817) 821-6970
Mailing address
107 RAMBLING TRL, WEATHERFORD, TX 76087-6892
(817) 821-6970
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
197-13815
TX
163WM0102X
Maternal Newborn Registered Nurse
222758
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2826661
—
TX
Enumeration date
05/15/2010
Last updated
01/23/2012
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