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Individual

NICHOLE BROEKHUIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN, CRNP

Contact information

Practice address
721 MIAMI CHAPEL RD, DAYTON, OH 45417-4650
(937) 281-6800
Mailing address
721 MIAMI CHAPEL RD, DAYTON, OH 45417-4650
(937) 901-2777

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-185641
AL
163W00000X
Registered Nurse
RN.423570
OH
363LP0200X
Pediatric Nurse Practitioner
1-185641
AL
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP0036317
OH

Other

Enumeration date
04/20/2021
Last updated
04/06/2026
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