Provider Demographics
NPI:1700594603
Name:BROADIE, MARSHA RENEE
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:RENEE
Last Name:BROADIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 50TH ST NE APT 129
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5438
Mailing Address - Country:US
Mailing Address - Phone:202-236-8443
Mailing Address - Fax:
Practice Address - Street 1:313 50TH ST NE APT 31
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5351
Practice Address - Country:US
Practice Address - Phone:202-489-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant