National Provider Identifier Database

SHANNON M BRODERSON, D.C. – NPI #1194888552
Chiropractor

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.


Contact Information

SHANNON M BRODERSON, D.C.
74-5620 PALANI RD
SUITE 102
KAILUA-KONA, HI96740-3640
Phone: 808-329-7797
Fax: 808-329-2748
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for SHANNON M BRODERSON

NPI Number 1194888552
Credentials D.C. (Doctor of Chiropractic)
Entity Individual
Enumeration date 12/18/2006
Last updated 06/15/2023 - About 3 years ago
Sole proprietor1 Yes
Identifiers
  • HI License #: DC977
  • HI Other: 244327 HMSA NUMBER
  • HI Other: H56328 P-TAN
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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