Individual
MRS. SAMANTHA MARIE BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
201 PLAZA DR STE A, SIKESTON, MO 63801-5110
(573) 472-2663
Mailing address
201 PLAZA DR STE A, SIKESTON, MO 63801-5110
(573) 472-2663
(573) 472-2669
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019020226
MO
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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