Individual
KIMBERLY BROADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APN-C
Contact information
Practice address
401 YOUNG AVE STE 180 FRONT, MOORESTOWN, NJ 08057-3139
(856) 291-8600
(856) 291-8610
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00497600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0434191
—
NJ
Enumeration date
07/28/2014
Last updated
12/13/2024
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