Broadus, Trent Michael

Broadus, Trent Michael is an sole proprietor health care provider with primary practice located at 1695 N Sunrise Way , Palm Springs CA 92262-3701. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Broadus, Trent Michael can be contacted via phone (760) 323-2118.

Contact Information

Primary practice address
1695 N Sunrise Way Palm Springs CA 92262-3701
Phone: (760) 323-2118
Fax: (760) 416-1651
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9353539 Florida
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 570228 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 95006008 California

Profile Details

NPI number 1780967364
LBN Legal business name Broadus, Trent Michael
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2011
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780967364 NPPES
California Other 95006008 CA NP LICENSE
California Other ARNP9353539 CA NP LICENSE

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