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General NPI Number Information
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NPI Number | 1093322984
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Entity Type | Organization
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Legal Business Name | BROADVIEW ENTERPRISES LLC
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 4222 BELL RD STE 5
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City | NEWBURGH
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State | IN
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Zip | 47630-2541
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Country | US
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Telephone | 812-758-3032
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Fax | 812-490-1025
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Provider Business Mailing Address
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Address Line | PO BOX 28227
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City | BELFAST
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State | ME
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Zip | 04915-2034
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD D VAUGHN
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Credential | NP
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Telephone | 812-758-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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