Erica Monic Broadnax
Community Health Worker in Florissant, MO. Individual provider (NPI-1).
NPI number1760160600
StatusActive
Last updated in NPPESJul 10, 2023
Details
- NPI
- 1760160600
- Entity type
- Individual (NPI-1)
- Name
- Erica Monic Broadnax
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 10, 2023
- Certification date
- Jul 10, 2023
- Last updated
- Jul 10, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
1150 Graham Rd Ste 102Florissant, MO 63031-8077
Phone 314-940-3081
Mailing address
1430 Olive St Ste 400Saint Louis, MO 63103-2303
Phone 314-206-3700
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