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NPI Code Detail

MEDICARE: ROSE BRODERICK NP

MEDICARE: ROSE BRODERICK NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF05250711MA

General Provider Information

NPI Number : 1548107725
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE BRODERICK NP
Provider Business Mailing Address
First Line : 20 1ST AVE
Second Line :
City : SCITUATE
State : MA
Zip : 02066-2806
Country : US
Telephone Number : 508-577-9032
Fax Number :
Provider Business Practice Location Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “ ROSE BRODERICK NP” Practice Location

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