Provider Demographics
NPI:1740697002
Name:BROOME, CHRISTOPHER KEN (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KEN
Last Name:BROOME
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1315
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29641-1315
Mailing Address - Country:US
Mailing Address - Phone:864-635-0376
Mailing Address - Fax:864-442-6848
Practice Address - Street 1:1923 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8885
Practice Address - Country:US
Practice Address - Phone:864-635-0376
Practice Address - Fax:864-442-6848
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily