Russell Kevin Broxson Jr., FNP BC
Nurse Practitioner, Family in Jay, FL. Individual provider (NPI-1).
NPI number1295587293
StatusActive
Last updated in NPPESApr 16, 2024
Details
- NPI
- 1295587293
- Entity type
- Individual (NPI-1)
- Name
- Mr. Russell Kevin Broxson Jr.
- Credential
- FNP BC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 3, 2024
- Certification date
- Apr 16, 2024
- Last updated
- Apr 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11031992 | FL | Yes |
Practice location
14114 Alabama StJay, FL 32565-1219
Phone 850-675-8000
Mailing address
5228 Medicine Bow StMilton, FL 32570-8149
Phone 850-449-4801
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 Family Nurse Practitioner providers in Jay, FL
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.