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MADISON MACKENZIE BRODERICK
NPI 1740910868
Student in an Organized Health Care Education/Training Program in Springfield, MO

Active since June 13, 2022
901 S NATIONAL AVE # PROF160, SPRINGFIELD, MO 65897(417) 836-8553 Get Directions Write a Review

NPPES record last updated: June 16, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Madison Mackenzie Broderick NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MADISON MACKENZIE BRODERICK (NPI 1740910868) is an individual student in an organized health care education/training program in Springfield, Missouri and active in the NPI registry since June 2022.

NPPES Registry Identity

NPI1740910868
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMADISON MACKENZIE BRODERICK
Location Address901 S NATIONAL AVE # PROF160Springfield, MO 65897-0027
Mailing Address5203 Patterson RdSaint Louis, MO 63129-2443 · (636) 692-3857
Phone(417) 836-8553
Sole ProprietorYes
Enumeration DateJune 13, 2022
Last NPPES UpdateJune 16, 2022
NPPES CertifiedJune 16, 2022
✔ NPI 1740910868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
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.

Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X
901 S NATIONAL AVE # PROF160, Springfield, MO 65897
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. COLE TIMOTHY BASSETT
Specialist/Technologist (Athletic Trainer)
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (417) 836-8553
WILLIAM BOAZ BURNEY
Student in an Organized Health Care Education/Training Program
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (417) 836-8553
ERIN R HAROLD ATC
Specialist/Technologist (Athletic Trainer)
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (913) 231-7882
AARON DURKALSKI AT
Student in an Organized Health Care Education/Training Program
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (417) 836-8553
SARAH FRINGER
Student in an Organized Health Care Education/Training Program
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (417) 836-8553
CALEB MORLAN
Specialist/Technologist (Athletic Trainer)
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (417) 836-8553
EDGARDO ANDRES SOTO RAMIREZ
Student in an Organized Health Care Education/Training Program
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (417) 836-8553
LOUIS D. BAILON
Specialist/Technologist (Athletic Trainer)
901 S NATIONAL AVE # PROF160
SPRINGFIELD, MO 65897
Greene County (908) 499-2022

Frequently Asked Questions

What is Madison Broderick's NPI number?

The NPI number assigned to this healthcare provider is 1740910868, enumerated as an "individual" on June 13, 2022.

Where is the provider located?

The provider is located at 901 S NATIONAL AVE # PROF160 SPRINGFIELD, MO 65897 and the phone number is (417) 836-8553.

What is the provider's specialty?

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.