Active NPI
Jane Frances Hines Broderick, RN
- Registered Nurse
- Greeley, CO
National Provider Identifier
1780167585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.0173620
- Practice address
- 1801 16TH St
Greeley, CO 80631-5154 - Phone
- (970) 810-4121
- NPI assigned
- Sep 8, 2018
- 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 | RN.0173620 | CO | Primary |
Addresses
Primary practice location
1801 16TH St
Greeley, CO 80631-5154
Mailing address
1519 Buttonwood Dr
Fort Collins, CO 80525-1917
Phone (970) 901-8104
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94-257-0836 | Other | CO | STATE OF COLORADO |
| 94-257-0836 | Other | CO | COLORADO DRIVERS LICENSE |
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 |
|---|---|---|---|
| RN.0173620 | CO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536364800000",
"number": "1780167585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 BUTTONWOOD DR",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805251917",
"telephone_number": "970-901-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 16TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806315154",
"telephone_number": "970-810-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES BRODERICK",
"first_name": "JANE",
"middle_name": "FRANCES",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-08",
"last_updated": "2018-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "RN.0173620",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF COLORADO",
"identifier": "94-257-0836",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO DRIVERS LICENSE",
"identifier": "94-257-0836",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.