Angela Morris Broadway, REGISTERED NURSE
Individual provider Active NPI Registered Nurse · Mocksville, NC
NPI 1972076354 · NPPES record last updated Feb 7, 2019
Key facts
- NPI
- 1972076354
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 281469 (NC)
- Practice address
- 342 S Salisbury St
Mocksville, NC 27028-2526 - Phone
- (336) 940-7664
- Fax
- (336) 940-7664
- NPI assigned
- Jan 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 281469 | NC | MD | Home Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broadway Nursing Services | Home Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 281469 | NC | |
| Infusion Therapy Registered Nurse | 163WI0500X | 281469 | NC | |
| Medical-Surgical Registered Nurse | 163WM0705X | 281469 | NC | |
| Pediatric Registered Nurse | 163WP0200X | 281469 | NC | |
| Pediatrics Physician | 208000000X | 281469 | NC | |
| Registered Nurse | 163W00000X | 281469 | NC | Yes |
Addresses
Primary practice location
342 S Salisbury St
Mocksville, NC 27028-2526
Mailing address
342 S Salisbury St
Mocksville, NC 27028-2526
Phone (336) 940-7664
Other providers in Mocksville, NC
- Jocelyn Bradburn
- Danielle Renee Bratton
- Bright Light Care LLC
- Bright Light Care LLC
- Broadway Nursing Services
- Annie V. Brown
- Cheyenne Brown
- Leigh Michelle Bryant
- BT Heart and Vascular Center, PLLC
- Sara Buchanan
All providers in Mocksville, NC · Registered Nurse in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2019. 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.