| NPI | 1881023828 |
|---|---|
| Other Name | MALLORY LEEANN BROADAWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR A003980) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A003980) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2021-05-03 |