Catherine Ann Olivia Broadway
Individual provider Active NPI Athletic Trainer · Wilmington, DE
NPI 1366076127 · NPPES record last updated Mar 7, 2020
Key facts
- NPI
- 1366076127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1947251 (DE)
- Practice address
- 1619 W 10TH St
Wilmington, DE 19805-2771 - Phone
- (302) 750-2934
- NPI assigned
- Mar 2, 2020
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1947251 | DE | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1947251 | DE | Yes |
Addresses
Primary practice location
1619 W 10TH St
Wilmington, DE 19805-2771
Mailing address
1619 W 10TH St
Wilmington, DE 19805-2771
Other practice location 1
8000 York Rd
Towson, MD 21252-2771
Phone (302) 750-2934
Other providers in Wilmington, DE
- Reanard Anthony Britt
- Amy L Britton
- Stephanie Britz
- Raushanah L Broadard
- Sataeya Broadnax
- Paige Ariana Brocato
- Paul Michael Brock III
- Sarah Brock
- Zachary Brock
- Michele Broder
All providers in Wilmington, DE · Athletic Trainer in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2020. 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.