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General NPI Number Information
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NPI Number | 1740697002
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Entity Type | Individual
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Provider Name | CHRISTOPHER KEN BROOME FNP
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Gender | Male
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1923 E MAIN ST
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City | DUNCAN
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State | SC
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Zip | 29334-8885
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Country | US
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Telephone | 864-635-0376
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Fax | 864-442-6848
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Provider Business Mailing Address
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Address Line | PO BOX 1315
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City | EASLEY
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State | SC
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Zip | 29641-1315
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Country | US
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Telephone | 864-635-0376
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Fax | 864-442-6848
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18810
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License Number State | SC
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