MR. RICHARD H BROACH (NPI# 1588605257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588605257 |
| Entity Type | Individual |
| Full Name | MR. RICHARD H BROACH |
| Credential | APNP |
| Practice Address |
309 E North St Waukesha WI 53188-3718 |
| Practice Telephone | 4146721353 |
| Practice Fax Number | 4143857552 |
| Mailing Telephone | 4146721353 |
| Mailing Fax Number | 4143857552 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2016-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
3576125 | WI | Behavioral Health & Social Service Providers |
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
4270 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 40995000 | 05 |
| Street Address |
309 E NORTH ST |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-3718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679579098 | Lucia C Roman-marcial | Pediatrics | 309 E North St, Waukesha, WI 53188-3718 | 2005-06-21 |
| 1194240028 | Neil Mitchell | Counselor | 309 E North St, Waukesha, WI 53188-3718 | 2017-08-11 |
| 1700221991 | Emily Rebecca Walz | Psychiatry & Neurology | 309 E North St, Waukesha, WI 53188-3718 | 2013-05-01 |
| 1659536969 | Bret Valentine | Family Medicine | 309 E North St, Waukesha, WI 53188-3718 | 2008-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871743138 | Carol Lynn Herzberg | Clinical Nurse Specialist | S89w23120 King Pkwy, Big Bend, WI 53103-9720 | 2008-09-23 |
| 1548214133 | Lorrie W Hylkema | Clinical Nurse Specialist | 306 N Brooks St, Va Csp, Madison, WI 53715-1002 | 2006-05-19 |
| 1457583163 | Diane Matilda Pivonka | Clinical Nurse Specialist | 1499 6th St, Green Bay, WI 54304-2252 | 2009-08-13 |
| 1194827253 | Debra A Day | Clinical Nurse Specialist | 300 4th St N, La Crosse, WI 54601-3228 | 2006-09-01 |
| 1790898294 | Mary Ellen Yahle | Clinical Nurse Specialist | 2524 E Webster Pl, Suite 203, Milwaukee, WI 53211-4253 | 2006-08-17 |
| 1558374892 | Jeannette Carmen Merrill | Clinical Nurse Specialist | 3520 Tower Ave, Superior, WI 54880-5335 | 2006-08-15 |
| 1962419382 | Kathleen Collins | Clinical Nurse Specialist | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2006-08-01 |
Please comment or provide details below to improve the information on MR. RICHARD H BROACH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.