Deseree Broddie

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

LPN059350 Issued in GA

Legal business name

DESEREE BRODDIE

Practice address

128 Stubbs LN
Bainbridge, GA 39817-1937

Phone

(229) 726-8253

NPI assigned

May 5, 2008

Last updated

May 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deseree Marie Broddie

Title

LPN

Phone

(229) 726-8253

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1033385406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 STUBBS LN",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398171937",
            "telephone_number": "229-726-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 STUBBS LN",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398171937",
            "telephone_number": "229-726-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESEREE BRODDIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "BRODDIE",
        "authorized_official_first_name": "DESEREE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "229-726-8253",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "LPN059350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Decatur County Board of Health
• Decatur County School System
• Decatur Emergency Physicians LLC
• Decatur Opco LLC (Riverside Place Personal Care Home)
• Leslie Ann Dellenbarger, PSY.D.
• Jackie Denise Dixon, LCSW
• Dena Cutts Donalson
• Margaret Howell Dudley
• Kristie Eakin, LPN
• Alicia S Estillore-Cruz, M.D.

• Nursing Care Agency in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.