Sarah Katherine Broadaway
Student in an Organized Health Care Education/Training Program in Jackson, MS. Individual provider (NPI-1).
NPI number1982431623
StatusActive
Last updated in NPPESSep 17, 2024
Details
- NPI
- 1982431623
- Entity type
- Individual (NPI-1)
- Name
- Sarah Katherine Broadaway
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 17, 2024
- Certification date
- Sep 17, 2024
- Last updated
- Sep 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
2500 N State StJackson, MS 39216-4500
Phone 662-255-3855
Mailing address
802 Lakeland Dr Apt 529Jackson, MS 39216-4655
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