Jane Louise Broughton, R.D.
Individual provider Active NPI Registered Dietitian · Chinle, AZ
NPI 1104988286 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104988286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 337040 (IL)
- Practice address
- Off Hwy 191 Hospital Road
Chinle, AZ 86503 - Phone
- (928) 674-7001
- Fax
- (928) 674-7705
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 337040 | IL | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 337040 | IL | Yes |
Addresses
Primary practice location
Off Hwy 191 Hospital Road
Chinle, AZ 86503
Mailing address
PO Box Drawer PH
Chinle, AZ 86503
Phone (928) 674-7001
Other providers in Chinle, AZ
- Natasha Renee Bitsui
- Ja'Nelle Maxine Blocker
- Ethan Reuvan Bornstein
- Jennifer Bosgra
- Edna A. Braxton
- Filip Miroslav Bryan
- Sheree Burbank
- Erik M Cala
- Jenna Rae Carlson
- Elaine Carrasco Cornelio
All providers in Chinle, AZ · Registered Dietitian in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.