Individual
DEBORAH ANN BROADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Mailing address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3754
CT
363LP2300X
Primary Care Nurse Practitioner
003754
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008004412
—
CT
Enumeration date
02/29/2008
Last updated
12/02/2014
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