STEPHANIE LAUREN BRODERICK CNM WHNP-BC NPI 1629444823

NPI Information

NPI: 1629444823
Provider Name: STEPHANIE LAUREN BRODERICK, CNM, WHNP-BC
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

PECOS Registration: Yes

Address:
1400 INDIAN AVE
AURORA, IL
ZIP 60505
Phone: (630) 892-4355
Get Directions

Stephanie Lauren Broderick, CNM, WHNP-BC is an obstetrics and gynecology nurse practitioner in Aurora, IL. Stephanie Lauren Broderick, CNM, WHNP-BC NPI is 1629444823. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 INDIAN AVE
AURORA, IL
ZIP 60505-137
Phone: (630) 892-4355

The NPI 1629444823 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/11/2015 and was last updated on 5/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	209013055	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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