Individual
AMANDA BROOMHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1507 RIVERY BLVD, GEORGETOWN, TX 78628-3058
(512) 509-9550
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1014431
TX
Other
Enumeration date
09/22/2020
Last updated
11/19/2021
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