Provider Demographics
NPI:1982104857
Name:BROYLES, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BROYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TIMBER CT APT 913
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-2363
Mailing Address - Country:US
Mailing Address - Phone:972-966-9973
Mailing Address - Fax:
Practice Address - Street 1:201 TIMBER CT APT 913
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2363
Practice Address - Country:US
Practice Address - Phone:972-966-9973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-17
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant