Individual
MRS. SANDRA BERNETTE BROOMFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
575 1ST ST, MACON, GA 31201-2825
(478) 742-7566
(478) 743-2804
Mailing address
575 1ST ST, MACON, GA 31201-2825
(478) 742-7566
(478) 743-2804
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN159851
GA
Other
Enumeration date
02/18/2019
Last updated
09/15/2020
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