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1144913708
TIA LEA BROADNAX
GREENSBORO, NC
NPI
1144913708
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NC 218830)
Enumeration Date
2023-05-31
Last Update Date
2023-05-31
Business Address
TIA LEA BROADNAX
1203 MAPLE ST
GREENSBORO, NC 27405-6910
Phone number: 336-840-5591
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Mailing Address
TIA LEA BROADNAX
1203 MAPLE ST
GREENSBORO, NC 27405-6910
Phone number: 336-840-5591
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