Individual provider · Type 1 NPI

Taeja Broadwater, PA-C

Surgical Physician Assistant · Danville, PA

NPI number 1114152329 Active

Practice location

Geisinger Medical Ctr, 100 North Academy Drive
Danville, PA 17822-0001

Mailing address

1015 Clifton Dr
Bloomsburg, PA 17815-3083

Specialties and licenses

TaxonomyCodeLicense
Medical-Surgical Registered Nurse 163WM0705XR185137 (MD)
Surgical Physician Assistant Primary 363AS0400XMAO55689 (PA)

Surgical Physician Assistant: Definition to come...

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About NPI 1114152329

Taeja Broadwater, PA-C's National Provider Identifier is 1114152329, issued on May 18, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Danville, PA. The record was last updated on Sep 27, 2013.