Daesean Broadwater
Individual provider Active NPI Homemaker · Wickliffe, OH
NPI 1285570911 · NPPES record last updated Apr 27, 2026
Key facts
- NPI
- 1285570911
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- Practice address
- 29706 Euclid Ave
Wickliffe, OH 44092-1831 - Phone
- (330) 840-8002
- NPI assigned
- Apr 27, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Homemaker |
376J00000X | OH | Yes |
Addresses
Primary practice location
29706 Euclid Ave
Wickliffe, OH 44092-1831
Mailing address
29706 Euclid Ave
Wickliffe, OH 44092-1831
Other providers in Wickliffe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2026. 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.