Active NPI
Melva June Broderick, R.N.
- Registered Nurse
- Boise, ID
National Provider Identifier
1427399690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- N-33864
- Practice address
- 6881 W State St
#8
Boise, ID 83714-7428 - Phone
- (208) 850-2653
- NPI assigned
- Mar 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | N-33864 | ID | Primary |
Addresses
Primary practice location
6881 W State St
#8
Boise, ID 83714-7428
Mailing address
6881 W State St
#8
Boise, ID 83714-7428
Phone (208) 850-2653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-33864 | ID | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363046400000",
"number": "1427399690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6881 W STATE ST",
"address_2": "#8",
"city": "BOISE",
"state": "ID",
"postal_code": "837147428",
"telephone_number": "208-850-2653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6881 W STATE ST",
"address_2": "#8",
"city": "BOISE",
"state": "ID",
"postal_code": "837147428",
"telephone_number": "208-850-2653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERICK",
"first_name": "MELVA",
"middle_name": "JUNE",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-12",
"last_updated": "2013-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ID",
"license": "N-33864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.