Kieron James Broderick, RN, ACNP

Nurse Practitioner · Centerville, IA

Individual Active NPI

NPI number 1174879282

Practice location

1208 E Cross St
Centerville, IA 52544-3501
Phone
(816) 477-7200

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NPI record

NPI
1174879282
Entity type
Individual (Type 1)
Enumeration date
July 25, 2012
Last updated
February 18, 2022
Certified
February 18, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X L166512 IA
Acute Care Nurse Practitioner 363LA2100X 2012024476 MO

Mailing address

3901 Spicewood Springs Rd Ste 201
Austin, TX 78759-8723
Phone
(877) 279-5960
Fax
(877) 384-3106

About Kieron Broderick

Kieron James Broderick, RN, ACNP is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 1208 E Cross St, Centerville, IA 52544-3501. The NPI number 1174879282 was assigned on July 25, 2012 and the record was last updated on February 18, 2022.

Kieron Broderick lists 2 licenses in the registry: #L166512 (IA) for Nurse Practitioner; #2012024476 (MO) for Acute Care Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kieron James Broderick, RN, ACNP?

The NPI number is 1174879282.

What is the phone number of Kieron Broderick?

The phone number listed for the practice location is (816) 477-7200.

Where is Kieron Broderick located?

1208 E Cross St, Centerville, IA 52544-3501.

What is the taxonomy code for Kieron Broderick?

The primary taxonomy code is 363L00000X – Nurse Practitioner; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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