Edith Broughton, RN
Registered Nurse, Home Health in Moreno Valley, CA. Individual provider (NPI-1).
NPI number1487324844
StatusActive
Last updated in NPPESSep 17, 2021
Details
- NPI
- 1487324844
- Entity type
- Individual (NPI-1)
- Name
- Ms. Edith Broughton
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 16, 2021
- Certification date
- Sep 17, 2021
- Last updated
- Sep 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WH0200X | Registered Nurse, Home Health | 409365 | CA | Yes |
| 163WG0000X | Registered Nurse, General Practice | 409365 | CA |
Practice location
13629 Erin DrMoreno Valley, CA 92555-2524
Phone 951-337-7860
Mailing address
13629 Erin DrMoreno Valley, CA 92555-2524
Phone 951-337-7860
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