Lookup NPI Numbers from the NPI Registry
NPI Profile for JERRIOD N BROADNAX in FAYETTEVILLE, AR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Counselor |
101Y00000X | |||
Professional |
101YP2500X |
| NPI Number | 1427116581 |
|
| Status | Active | |
| Credentials | LADAC, NCAC-II, CFC | |
| Entity | Individual | |
| Enumeration date | 12/04/2006 | |
| Last updated | 08/10/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JERRIOD N BROADNAX
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JERRIOD N BROADNAX, LADAC, NCAC-II, CFC