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Individual

MS. THERESA MICHELLE BRODEUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1600 S 48TH ST, LINCOLN, NE 68506-1283
(402) 481-1111
Mailing address
2731 SEDALIA CIR, LINCOLN, NE 68516-4627
(315) 447-3130

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
09/03/2014
Last updated
03/27/2017
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