Doctor Name: | MARTHA BROUGH |
NPI Number: | 1063601136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | RN21245 |
Business Practice Address: | 450 Clinton St Thundermist Health Center Woonsocket, RI - 028953207 |
Business Phone Number: | 4017674100 |
Business Fax Number: | 4012356899 |
Mailing Address: | 450 Clinton St, Thundermist Health Center WOONSOCKET |
State: | RI |
Postal Code: | 028953207 |
Phone Number: | 4017674100 |
Fax Number: | 4012356899 |
NPI Enumeration Date: | 10/15/2007 |
NPI Last Update Date: | 06/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WD0400X |
License Number: | RN21245 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | RI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Diabetes Educator |
Taxonomy Definition: |