Individual
MS. TREKESHA D BROADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
EMILE @ 42ND ST, OMAHA, NE 68198
(402) 559-0692
(402) 559-6779
Mailing address
1120 15TH STREET, OR-6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
112359
NE
363LA2100X
Acute Care Nurse Practitioner
Primary
RN168369
GA
Other
Enumeration date
03/07/2013
Last updated
09/16/2021
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