| Doctor Name: | MRS. S DIANNE BROAD |
| NPI Number: | 1902950868 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | UP001335K |
| Business Practice Address: | 1 Morrow Way Mclachlan Student Health Center Slippery Rock, PA - 160571326 |
| Business Phone Number: | 7247382052 |
| Business Fax Number: | 7247382078 |
| Mailing Address: | 1 Morrow Way, Mclachlan Student Health Center SLIPPERY ROCK |
| State: | PA |
| Postal Code: | 160571326 |
| Phone Number: | 7247382052 |
| Fax Number: | 7247382078 |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | UP001335K |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |