SUSAN ELAINE BROYLES (NPI# 1720352818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720352818 |
| Entity Type | Individual |
| Full Name | SUSAN ELAINE BROYLES |
| Credential | CRNP |
| Practice Address |
480 Honeysuckle Rd Dothan AL 36305-1156 |
| Practice Telephone | 3348361212 |
| Practice Fax Number | 3348361888 |
| Mailing Telephone | 3348361212 |
| Mailing Fax Number | 3348361888 |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-114743 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869001 | Susan Margaret Broyles | Technician | 3148 Belvedere Dr, Riverside, CA 92507-3205 | 2019-09-11 |
| 1801247762 | Susan Broyles | Registered Nurse | 2045 Westgate Dr, Suite 100, Bethlehem, PA 18017-7480 | 2016-06-22 |
| Street Address |
480 HONEYSUCKLE RD |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518922087 | Travis J Rutland | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2006-04-19 |
| 1992202741 | Laboratory Corportation of America Holdings | Clinical Medical Laboratory | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2018-04-09 |
| 1679941884 | Breeann Gilmore | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2015-09-03 |
| 1992055883 | Nicholas Cody Mendheim | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-09-18 |
| 1679835532 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-06-15 |
| 1689932022 | Gypsy Rain Glover | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2012-04-23 |
| 1790075950 | George Augustus Nelson Iv | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2011-04-08 |
| 1396044426 | Amy Cole Ethridge | Nurse Practitioner | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2011-03-15 |
| 1588981872 | Scott Andrew Sarrels | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2010-04-26 |
| 1386769404 | Paul Brandon Lamb | Internal Medicine | 480 Honeysuckle Rd, Dothan, AL 36305-1156 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295362408 | Stephen M Pendergraft | Nurse Practitioner | 4740 W Main St, Dothan, AL 36305-9423 | 2020-03-26 |
| 1689205767 | Sassy Lashawn Sylvester | Nurse Practitioner | 410 Ridgeland Rd, Dothan, AL 36301-1117 | 2020-01-28 |
| 1700344488 | Gregory Keith Tice | Nurse Practitioner | 1118 Ross Clark Cir Ste 704, Dothan, AL 36301-3030 | 2019-03-12 |
| 1144732520 | Kasey Duffie Chance | Nurse Practitioner | 211 Brushfire Dr, Dothan, AL 36305-7069 | 2017-10-25 |
| 1306364062 | Janeetra Janiece Coachman | Nurse Practitioner | 9 Trillium Cir Apt 1401, Dothan, AL 36301-7653 | 2017-09-01 |
| 1265954010 | Melanie Jo Ellison | Nurse Practitioner | 973 Dunn Rd, Dothan, AL 36303-1056 | 2017-07-13 |
| 1679012629 | Elva Calderon | Nurse Practitioner | 1736 E Main St Ste 100, Dothan, AL 36301-3040 | 2017-02-22 |
| 1649610395 | Kelli Saage Anderson | Nurse Practitioner | 1146 Ross Clark Cir, Dothan, AL 36301-3022 | 2013-06-26 |
| 1902040090 | Cindy Ruth Hemendinger | Nurse Practitioner | 3124 Ross Clark Cir, Dothan, AL 36303-3038 | 2009-04-21 |
| 1770737249 | Kelley E Blake | Nurse Practitioner | 4300 W Main St Ste 45, Dothan, AL 36305-1317 | 2008-11-11 |
| Find all providers in DOTHAN | ||||
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| 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.