Letrelle Diane Broaden
Individual provider Active NPI Private Vehicle · Dickson, TN
NPI 1194409748 · NPPES record last updated Jun 14, 2023
Key facts
- NPI
- 1194409748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- Practice address
- 100 Batey Cir Ste C
Dickson, TN 37055-1044 - Phone
- (877) 676-1399
- Fax
- (931) 236-0024
- NPI assigned
- Jun 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | Yes |
Addresses
Primary practice location
100 Batey Cir Ste C
Dickson, TN 37055-1044
Mailing address
100 Batey Cir Ste C
Dickson, TN 37055-1044
Phone (517) 410-1857
Other providers in Dickson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2023. 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.