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Luisa Broden
Student in an Organized Health Care Education/Training Program in Moscow, Idaho
NPI 1003434283

Luisa Broden is a Student in an Organized Health Care Education/Training Program based in Colville, ID. Luisa Broden practices in Moscow, ID. The NPI Number for Luisa Broden is 1003434283 and holds a License No. (Idaho).

The current practice location address for Luisa Broden is 902 N Almon St Apt 3, Moscow, ID and can be reached out via phone at 509-675-3813.

Location: 902 N Almon St Apt 3, Moscow, ID, 99114-9463
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003434283
Provider Name
Luisa Broden
Credential
Provider Entity Type
Individual
Gender
Female
Address
902 N Almon St Apt 3, Moscow, ID, 99114-9463
Phone Number
509-675-3813
Fax Number
Provider Enumeration Date
07/14/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
UDWW750166632 01 WA REGENCE
institution
Provider Business Practice Location Address Details
Address
902 N Almon St Apt 3
City
Moscow
State
Idaho
Zip
83843-8544
Phone Number
509-675-3813
Fax Number
person
Provider Business Mailing Address Details
Address
902 N Almon St Apt 3
City
Moscow
State
Idaho
Zip
83843-8544
Phone Number
509-675-3813
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Idaho)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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