S Dianne Broad, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

UP001335K Issued in PA

Practice address

1 Morrow Way
McLachlan Student Health Center
Slippery Rock, PA 16057-1326

Phone

(724) 738-2052

Fax

(724) 738-2078

NPI assigned

Jan 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss S Dianne Dawson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902950868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MORROW WAY",
            "address_2": "MCLACHLAN STUDENT HEALTH CENTER",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160571326",
            "telephone_number": "724-738-2052",
            "fax_number": "724-738-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MORROW WAY",
            "address_2": "MCLACHLAN STUDENT HEALTH CENTER",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160571326",
            "telephone_number": "724-738-2052",
            "fax_number": "724-738-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROAD",
        "first_name": "S",
        "middle_name": "DIANNE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "UP001335K",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "S",
            "last_name": "DAWSON",
            "middle_name": "DIANNE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Michelle Belavic, PHARMD
• Kristina Benkeser, MSN, CRNP
• BHS Fastercare PLLC
• Abigail Leigh Biddle, DR
• Erin Boyer, LPC
• Butler Medical Providers (Slippery Rock Family Medicine Division)
• Paul Andrew Cacolice, A.T.,C.
• Linda L Campbell, CRNP
• Celestin Mindcare PLLC (TLC Mindful Solutions)
• Teresa Lynn Celestin, DNP, PMHNP, CRNP

• Adult Health Nurse Practitioner in Slippery Rock, PA
• Providers in Slippery Rock, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.