Individual
CHARLENE SUE BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
GILL HEART INSTITUTE 800 ROSE ST, G100, LEXINGTON, KY 40536-0093
(859) 323-0295
(859) 257-8699
Mailing address
225 HOSPITAL DR, STE 300A, WINCHESTER, KY 40391-7604
(859) 323-3976
(859) 257-6060
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4695P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801709200
—
KY
Enumeration date
10/18/2006
Last updated
07/20/2016
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