Individual
TIFFANY BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
1100 E WENDOVER AVE, GREENSBORO, NC 27405-6713
(336) 641-4592
Mailing address
515 ASH ST, EDEN, NC 27288-4829
(336) 589-9833
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2404435
NC
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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