Luisa Broden

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

902 N Almon St Apt 3
Moscow, ID 83843-8544

Phone

(509) 675-3813

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 14, 2020.

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1003434283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E 9TH AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991149463",
            "telephone_number": "509-675-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N ALMON ST APT 3",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838438544",
            "telephone_number": "509-675-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEN",
        "first_name": "LUISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "UDWW750166632",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Corinne Bradford, LMP
• Allison Jean Grace Branson
• Valerie Olivia Branson, RDN
• Kalina Brar
• Tenli Bright
• Kari Brody, D.A.T., A.T., L.A.T.
• Lauren Brogis, M.D.
• Sam Brosseau
• Ellenmarie Zwank Brown, M.D
• John Barclay Brown III, MD

• All providers in Moscow, ID
• Student in an Organized Health Care Education/Training Program in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.