| NPI | 1306133095 |
|---|---|
| Former Name | DEBRA LEE BRODERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77305-031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 108186) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-108186) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2022-07-16 |