Stacy Ann Broughton, REGISTERED NURSE

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

163175 Issued in WI

Practice address

W161N9517 Blackfoot Dr
Menomonee Falls, WI 53051-1565

Phone

(414) 795-4257

NPI assigned

May 2, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1013590637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W161N9517 BLACKFOOT DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530511565",
            "telephone_number": "414-795-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W161N9517 BLACKFOOT DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530511565",
            "telephone_number": "414-795-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "STACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WI",
            "license": "163175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Britt, OTR
• Christy M. Brochhausen, PA
• Roderick Scott Brodhead, MD
• Nicola Brodlo, M.S.W.
• Patrick J Brody, MD
• Amanda May Brown
• Stephanie Bruder, APNP
• Kellen Michael Brush
• Daniel Bruss
• James Buck, M.D.

• General Practice Registered Nurse in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• General Practice Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.