Broderick, Laura Kay

Broderick, Laura Kay is an individual health care provider with primary practice located at 1755 N Barker Rd , Brookfield WI 53045-1801. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Broderick, Laura Kay can be contacted via phone (262) 821-3939.

Contact Information

Primary practice address
1755 N Barker Rd Brookfield WI 53045-1801
Phone: (262) 821-3939
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 722026 Wisconsin

Profile Details

NPI number 1811132475
LBN Legal business name Broderick, Laura Kay
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2008
Last updated Dec 11th, 2008 - about 18 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 1811132475 NPPES
Wisconsin Other 722026 STATE LICENSE
Wisconsin MEDICAID 40649500 STATE LICENSE

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