Broad, Jerome

Broad, Jerome is an individual health care provider with primary practice located at 555 N Duke St , Lancaster PA 17602-2250. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Broad, Jerome can be contacted via phone (717) 544-5511.

Contact Information

Primary practice address
555 N Duke St Lancaster PA 17602-2250
Phone: (717) 544-5511
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN326693L Pennsylvania

Profile Details

NPI number 1013976109
LBN Legal business name Broad, Jerome
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2006
Last updated Mar 30th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013976109 NPPES
Pennsylvania Other 4574637 AETNA-NON HMO
Pennsylvania Other 50055744 AETNA-NON HMO
Pennsylvania Other 0229988000 AETNA-NON HMO
Pennsylvania Other 50055744 AETNA-NON HMO
Pennsylvania Other 1147543 AETNA-NON HMO
Pennsylvania Other P00233842 AETNA-NON HMO
Pennsylvania Other 000535767 AETNA-NON HMO
Pennsylvania Other 106579 AETNA-NON HMO

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