Broderick, Anthony R

Broderick, Anthony R is an individual health care provider with primary practice located at 2003 Kootenai Health Way , Coeur D Alene ID 83814-6051. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Broderick, Anthony R can be contacted via phone (208) 625-5185.

Contact Information

Primary practice address
2003 Kootenai Health Way Coeur D Alene ID 83814-6051
Phone: (208) 625-5185
Fax: (208) 625-6892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP675A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN33608 Idaho

Profile Details

NPI number 1194820555
LBN Legal business name Broderick, Anthony R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Aug 28th, 2019 - about 6 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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