Individual provider · NPI-1

Scott Broadnax

Community Health Worker · Indianapolis, IN

NPI number1053715284
StatusActive
Last updated in NPPESOct 17, 2014

Details

NPI
1053715284
Entity type
Individual (NPI-1)
Name
Scott Broadnax
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 17, 2014
Last updated
Oct 17, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes

Practice location

8063 Madison Ave # 246
Indianapolis, IN 46227-6001

Phone 317-750-0435

Mailing address

8063 Madison Ave # 246
Indianapolis, IN 46227-6001

Phone 317-750-0435

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 Community Health Worker providers in Indianapolis, IN