Individual
CLYDENA JEAN BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP - C
Contact information
Practice address
4111 1ST AVE STE 3, NITRO, WV 25143-1345
(304) 755-4797
(304) 755-4799
Mailing address
140 HICKORY RD # 4, CHARLESTON, WV 25314-1824
(304) 752-1669
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024183957
VA
363LF0000X
Family Nurse Practitioner
APRN62736-NP-C
WV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
62736
WV
Other
Enumeration date
08/17/2010
Last updated
10/16/2024
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