CORI CLARK BROADHEAD (NPI# 1033750401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033750401 |
Entity Type | Individual |
Full Name | CORI CLARK BROADHEAD |
Practice Address |
516 Quintard Ave Anniston AL 36201-5711 |
Mailing Address |
216 Elder St Irondale AL 35210-2504 |
Practice Telephone | 2567419799 |
Practice Fax Number | 2567419795 |
Enumeration Date | 2019-10-07 |
Last Update Date | 2019-10-23 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
201914904 | AL | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
500 Cahaba Park Cir, Birmingham, AL 352425087 | 2058482273 |
Street Address |
516 QUINTARD AVE |
City | ANNISTON |
State | AL |
Zip Code | 36201-5711 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982665519 | Gary M Ray | Pediatrics | 516 Quintard Ave, Anniston, AL 36201-5711 | 2006-03-31 |
1003387309 | Amanda Marie Pearson | Nurse Practitioner | 516 Quintard Ave, Anniston, AL 36201-5711 | 2018-12-12 |
1558723106 | Amanda Hall | Nurse Practitioner | 516 Quintard Ave, Anniston, AL 36201-5711 | 2016-03-23 |
1487031530 | Kristin Michelle Gsell | Registered Nurse | 516 Quintard Ave, Anniston, AL 36201-5711 | 2015-04-28 |
1659774693 | Elizabeth Taylor Tucker | Nurse Practitioner | 516 Quintard Ave, Anniston, AL 36201-5711 | 2014-10-06 |
1568800555 | Rebecca Allison Thompson | Pediatrics | 516 Quintard Ave, Anniston, AL 36201-5711 | 2013-06-12 |
1821248451 | Maria Marchenko | Pediatrics | 516 Quintard Ave, Anniston, AL 36201-5711 | 2008-09-18 |
1790971166 | Purohit Pediatric Clinic, LLC | Clinic/Center | 516 Quintard Ave, Anniston, AL 36201-5754 | 2007-09-19 |
1396759452 | Naresh Purohit | Pediatrics | 516 Quintard Ave, Anniston, AL 36201-5754 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528587367 | Populations and Interventions Team Company | Psychologist | 2518 Ammons St, Anniston, AL 36201 | 2017-09-13 |
1598209330 | Olivia Ann Couch | Nurse Practitioner | 801 Noble Street, Suite 400, Anniston, AL 36201 | 2016-12-13 |
1700332657 | Grace Therapeutic & Counseling Services Inc | Psychologist | 7 East 13th St Suite 225, Anniston, AL 36201 | 2016-08-31 |
1902287295 | Christy Darline Myrick | Nurse Practitioner | 7 Frankford Avenue, Bldg 52, Anniston, AL 36201 | 2015-06-12 |
1922364470 | Timothy Jay Rolfe | Social Worker | 7 Frankford Ave (bldg 221), Anniston Army Depot, Anniston, AL 36201 | 2012-04-10 |
1568794840 | Alan D. Lindell | Counselor | 1400 Noble St., Anniston, AL 36201 | 2010-02-11 |
1679726327 | Angela Lareese Fears-curry | Radiology Practitioner Assistant | 21 B E 11th Street, Anniston, AL 36201 | 2008-10-28 |
1265512453 | Bonita Stopa Harris | Chiropractor | 100 E 16th, Anniston, AL 36201 | 2006-10-16 |
1902999071 | John T Nelson | Dentist | 909 South Quintard Avenue, Anniston, AL 36201 | 2006-10-02 |
1598705071 | Jeffery K Sewell | Emergency Medicine | 1325 Quintard Ave, Anniston, AL 36201 | 2006-06-06 |
Find all providers in zip 36201 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962696005 | Amy M Matson | Nurse Practitioner | 516b Quintard Ave, Anniston, AL 36201-5754 | 2007-08-31 |
1285146100 | Katie Covington Smith | Nurse Practitioner | 3312 Henry Rd, Anniston, AL 36207-6344 | 2017-11-01 |
1366894404 | Amy Wadsworth | Nurse Practitioner | 1001 Leighton Ave, Anniston, AL 36207-5701 | 2016-07-12 |
1558723106 | Amanda Hall | Nurse Practitioner | 516 Quintard Ave, Anniston, AL 36201-5711 | 2016-03-23 |
1659774693 | Elizabeth Taylor Tucker | Nurse Practitioner | 516 Quintard Ave, Anniston, AL 36201-5711 | 2014-10-06 |
1043446800 | Holly Flanagan Mays | Nurse Practitioner | 3312 Henry Rd, Anniston, AL 36207-6344 | 2009-06-08 |
1922018209 | Charles E Thomas | Nurse Practitioner | 3312 Henry Rd, Anniston, AL 36207-6344 | 2006-08-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225636038 | Samantha Thompson | Nurse Practitioner | 1600 7th Ave S Fl 2, Birmingham, AL 35233-1711 | 2020-10-14 |
1831722289 | Tiffany Garrett | Nurse Practitioner | 333 Whitesport Dr Sw Ste 104, Huntsville, AL 35801-3455 | 2020-02-13 |
1033776612 | Erin Tracy Swing | Nurse Practitioner | 1600 7th Ave S Fl Apass2, Birmingham, AL 35233-1711 | 2019-05-20 |
1629531181 | Holley Lewis Collins | Nurse Practitioner | 1601 Center St Ste 1a, Mobile, AL 36604-1541 | 2019-04-11 |
1023591245 | Katherine Leigh Cassidy | Nurse Practitioner | 2001 Fieldstown Rd, Gardendale, AL 35071-4628 | 2018-09-13 |
1588145544 | Allison Mcdill Williams | Nurse Practitioner | 1101 Stephen J White Memorial Boulevard, Talladega, AL 35160 | 2018-08-27 |
1740769801 | Amy Leigh Jenkins | Nurse Practitioner | 1600 7th Ave S Bldg Suit5604, Birmingham, AL 35233-1711 | 2018-08-09 |
1467931949 | Kelly M Bonnett | Nurse Practitioner | 117 N Chalkville Rd, Trussville, AL 35173 | 2018-08-07 |
1184102931 | Molly Dixon Bolton | Nurse Practitioner | 1600 7th Ave S Bldg Suite620, Birmingham, AL 35233-1711 | 2018-08-03 |
1760968580 | Gladys Cooks | Nurse Practitioner | 8517 Highlands Trce, Trussville, AL 35173-3815 | 2018-07-15 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.