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General NPI Number Information
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NPI Number | 1528803970
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Entity Type | Individual
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Provider Name | YOLANDA DENISE BROADNAX CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 2344 DOWLEN RD
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City | BEAUMONT
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State | TX
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Zip | 77706-2537
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Country | US
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Telephone | 409-898-1603
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Fax |
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Provider Business Mailing Address
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Address Line | 801A S 11TH ST
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City | NEDERLAND
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State | TX
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Zip | 77627-3011
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Country | US
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Telephone | 334-391-9889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 1-095576
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 1169525
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License Number State | TX
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