Broadway Family Clinic LLC
NPI #1427566694 in Bloomfield, Missouri
Provider Information
- NPI Number
- 1427566694
- Entity Type
- Organization
- Organization Name
- Broadway Family Clinic LLC
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Jan 22, 2018
- Last Updated
- Aug 8, 2023
Practice Location
- Address
- 612 STATE HIGHWAY 25 S
- City
- Bloomfield
- State
- Missouri
- ZIP Code
- 63825-9566
- Phone
- (573) 803-3995
Authorized Official
- Name
- MELISSA JARRELL
- Title
- OFFICE/BILLING SUPERVISOR
- Phone
- (573) 568-7377
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
| Nurse Practitioner - Family — Family |
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