Stacy Ann Broughton, Registered Nurse
Registered Nurse, General Practice in Menomonee Falls, WI. Individual provider (NPI-1).
NPI number1013590637
StatusActive
Last updated in NPPESMay 2, 2021
Details
- NPI
- 1013590637
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Stacy Ann Broughton
- Credential
- Registered Nurse
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 2, 2021
- Certification date
- May 2, 2021
- Last updated
- May 2, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WG0000X | Registered Nurse, General Practice | 163175 | WI | Yes |
Practice location
W161n9517 Blackfoot DrMenomonee Falls, WI 53051-1565
Phone 414-795-4257
Mailing address
W161n9517 Blackfoot DrMenomonee Falls, WI 53051-1565
Phone 414-795-4257
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other General Practice Registered Nurse providers in Menomonee Falls, WI
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