Stephanie Broadhurst, MSN, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

655419 Issued in TX

Practice address

14419 Fair Knoll Way
Houston, TX 77062-2029

Phone

(281) 804-4337

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1992569826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14419 FAIR KNOLL WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770622029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14419 FAIR KNOLL WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770622029",
            "telephone_number": "281-804-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADHURST",
        "first_name": "STEPHANIE",
        "credential": "MSN, RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "655419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brli-Genpath Diagnostics, Inc
• Broad Health Texas International
• Kristen Broaddus, NP
• Lisa Bowen Broadfoot
• Kayla Broadhead, RD, LD, CNSC
• Broadstone Neurology Group LLC
• Broadway Dental & Braces PLLC
• Broadway Health Group LLC
• Broadway Medical Clinic, P.a.
• Broadway Pharmacy

• Lactation Consultant (Registered Nurse) in Houston, TX
• Providers in Houston, TX by specialty
• Lactation Consultant (Registered Nurse) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.