| Doctor Name: | NANCY A VANDER BROEK |
| NPI Number: | 1679541072 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | 02420 |
| Business Practice Address: | 405 Monroe St Pella, IA - 502191189 |
| Business Phone Number: | 6416283832 |
| Business Fax Number: | 6416288894 |
| Mailing Address: | 405 Monroe St, PELLA |
| State: | IA |
| Postal Code: | 502191189 |
| Phone Number: | 6416283832 |
| Fax Number: | 6416288894 |
| NPI Enumeration Date: | 03/10/2006 |
| NPI Last Update Date: | 10/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |