| Doctor Name: | WHITNEY JOHNSON BROADWELL |
| NPI Number: | 1306185400 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 203589 |
| Business Practice Address: | 15269 Indian Mound Rd Ware Shoals, SC - 296923547 |
| Business Phone Number: | 8644567496 |
| Business Fax Number: | 8648614338 |
| Mailing Address: | 15269 Indian Mound Rd, WARE SHOALS |
| State: | SC |
| Postal Code: | 296923547 |
| Phone Number: | 8644567496 |
| Fax Number: | 8648614338 |
| NPI Enumeration Date: | 02/08/2013 |
| NPI Last Update Date: | 02/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 203589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |