Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH K BRODERICK
ActiveChild & Adolescent Psychiatric Nurse · COLVILLE, WA
Registration Details
- NPI Number
- 1992217202
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 26, 2017 (8.5200901628163 yrs)
- Last Updated
- Oct 26, 2017
- License
-
RN60039364 (WA)
Practice Information
- Address
-
982 E COLUMBIA AVE STE 201COLVILLE, WA, 991143316Browse WA providers · Browse ZIP 99114
- Phone
- 5096855000
- Fax
- 5096845286
- Primary Specialty
-
Child & Adolescent Psychiatric Nurse
163WP0808X
Other Child & Adolescent Psychiatric Nurse Providers in COLVILLE, WA
| Name | Credential | NPI |
|---|---|---|
| MRS. LORRIE LARAY SAMPSON | RN | 1114206786 |
| MARCIA L MACAFEE | — | 1497266381 |
| CHAD MCLAIN | — | 1093226987 |
| KATHLEEN J BOSCH | — | 1578075883 |
| LISA C LUITEN | — | 1861904104 |
| LANA L DAVIES | — | 1588176895 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.