Broadwater, Taeja

Broadwater, Taeja is an sole proprietor health care provider with primary practice located at Geisinger Medical Ctr 100 North Academy Drive, Danville PA 17822-0001. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Broadwater, Taeja can be contacted via phone (570) 271-5555.

Contact Information

Primary practice address
Geisinger Medical Ctr 100 North Academy Drive Danville PA 17822-0001
Phone: (570) 271-5555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X R185137 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X MAO55689 Pennsylvania

Profile Details

NPI number 1114152329
LBN Legal business name Broadwater, Taeja
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 18th, 2009
Last updated Sep 27th, 2013 - about 13 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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