Individual
NICOLE M BRODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
Mailing address
1441 N 12TH ST FL 1, PHOENIX, AZ 85006-2837
(602) 521-5981
(602) 521-5981
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101284289
VA
208600000X
Surgery Physician
101284289
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2019
Last updated
06/26/2025
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