Erica Marie Broaders

Individual provider Active NPI In Home Supportive Care Agency · Camby, IN

NPI 1245084573 · NPPES record last updated Apr 15, 2024

Key facts

NPI
1245084573
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
License
24-016903-1 (IN)
Practice address
8337 Sansa St
Camby, IN 46113-8753
Phone
(219) 999-4447
NPI assigned
Apr 15, 2024
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

State licenses

LicenseStateTypeSpecialty
24-016903-1INMDIn Home Supportive Care Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 24-016903-1 IN Yes

Addresses

Primary practice location

8337 Sansa St
Camby, IN 46113-8753

Mailing address

8337 Sansa St
Camby, IN 46113-8753
Phone (219) 999-4447

Other providers in Camby, IN

All providers in Camby, IN · In Home Supportive Care Agency in Indiana

Sources for this page

Verify at the official NPI Registry.