Susan Broadway, R.N., N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

332697 Issued in CA

Practice address

1 Cyclotron Rd
Ms26R0143
Berkeley, CA 94720-8099

Phone

(510) 486-6951

Fax

(510) 486-7192

NPI assigned

Apr 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1154708956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CYCLOTRON RD",
            "address_2": "MS26R0143",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947208099",
            "telephone_number": "510-486-6951",
            "fax_number": "510-486-7192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CYCLOTRON RD",
            "address_2": "MS26R0143",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947208099",
            "telephone_number": "510-486-6951",
            "fax_number": "510-486-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWAY",
        "first_name": "SUSAN",
        "credential": "R.N., N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "332697",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "332697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Peterson Brill
• Brilliant Births
• Gemilyn E Bringas, BSN, RN, PHN, IBCLC
• Sarah Brinkman, AMFT
• Evelyn Briori, RD
• Phoebe Brock-Dolas
• Kimberly L Brodsky, PHD
• Bennett Roy Brodwin, DMD
• Monika Silvia Broecker, MS, MA
• Jessica Broitman, PHD

• Adult Health Nurse Practitioner in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.