DUANE BRODERICK (NPI# 1285921643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285921643 |
| Entity Type | Individual |
| Full Name | DUANE BRODERICK |
| Practice Address |
2311 Parke Ave., Ste. 8 Burley ID 83350 |
| Practice Telephone | 2088783350 |
| Practice Fax Number | 2088783351 |
| Mailing Telephone | 2088783350 |
| Mailing Fax Number | 2088783351 |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LMSW3064 | ID | Behavioral Health & Social Service Providers |
| Street Address |
2311 PARKE AVE., STE. 8 |
| City | BURLEY |
| State | ID |
| Zip Code | 83350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417349515 | Robbie Joe Carroll | Registered Nurse | 1024 8th Street, Family Health Services, Rupert, ID 83350 | 2015-02-26 |
| 1598798282 | Kerry W Saurey | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| 1093761694 | Family Health Services Corporation | Dental Hygienist | 402 6th St, Rupert, ID 83350 | 2006-05-25 |
| 1376531004 | Jeffrey Scott Swenson | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2005-10-06 |
| 1205312774 | Shawna M Mccaffrey | Nurse Practitioner | 1308 8th St, Rupert, ID 83350 | 2018-07-17 |
| 1386872810 | Brian R Muir | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2009-06-23 |
| 1083816334 | Cameron Mchan | Nurse Practitioner | 1308 8th St Ste 1, Rupert, ID 83350 | 2007-05-31 |
| 1134225956 | Margo Saunders | Specialist | 1308 8th St Ste 1, Rupert, ID 83350 | 2006-09-16 |
| 1619900305 | Don C Pates | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| 1740680404 | Peggy Goodman | Physical Therapist | 610 18th St, Rupert, ID 83350-1027 | 2014-09-01 |
| Find all providers in zip 83350 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710503909 | Family Health Services Corporation | Counselor | 700 W 16th St, Burley, ID 83318-1710 | 2020-06-23 |
| 1922661404 | Family Health Services Corporation | Counselor | 1010 W 17th St, Burley, ID 83318-1746 | 2019-04-19 |
| 1952847857 | Andrea Gochnour | Counselor | 531 E 5th St, Burley, ID 83318-1469 | 2017-01-16 |
| 1518326263 | Garrett Condie | Counselor | 1321 Oakley Ave, Burley, ID 83318-1859 | 2016-02-22 |
| 1396137527 | Natalie Fern Bell | Counselor | 658 Overland Ave Ste 8, Burley, ID 83318-1300 | 2015-02-25 |
| 1295023711 | Susannah Marie West | Counselor | 2271 Overland Ave Ste 5, Burley, ID 83318-2957 | 2011-07-18 |
| 1841307188 | A Plus Solutions | Counselor | 2311 Park Ave, Unit 3 Suite 12, Burley, ID 83318-2170 | 2006-08-24 |
| 1477106995 | Nancy Manrique | Counselor | 531 E 5th St, Burley, ID 83318-1469 | 2019-07-23 |
| 1023513777 | Nohemi Vasquez | Counselor | 2223 Overland Ave, Burley, ID 83318-2929 | 2018-03-26 |
| 1932647542 | Lynne Eppers | Counselor | 531 E 5th St, Burley, ID 83318-1469 | 2017-02-02 |
| Find all providers in BURLEY | ||||
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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.