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Contact Information

BRODERICK NYKAZA
2803 MEDICAL CAMPUS DR. SEYMOUR JOHNSON AFB
GOLDSBORO, NC27531
 Phone: 919-722-1802
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for BRODERICK NYKAZA · (Male)

NPI # 1396456307
Status Active
Credentials
Entity Individual
Enumeration date 12/09/2022
Last updated 01/29/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-13783
Hospital affiliation(s) Not Available
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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