| Jennifer Laura Broadt, PA | |
|
915 Wisconsin Ave, Tieton, WA 98947-9802 | |
| (509) 673-0044 | |
| (509) 673-0054 |
| Full Name | Jennifer Laura Broadt |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 915 Wisconsin Ave, Tieton, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962869776 | NPI | - | NPPES |
| 354348001 | Medicaid | TX | |
| 354348002 | Other | TX | CSHCN MEDICAID |
| 8860NU | Other | TX | SOLO BCBS |
| 47272ZSJC | Other | TX | MEDICARE |
| P01610841 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA60703623 (Washington) | Primary |
| 363A00000X | Physician Assistant | (Texas) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Laura Broadt, PA 501 S 5th Ave, Yakima, WA 98902-3550 Ph: (509) 494-6700 | Jennifer Laura Broadt, PA 915 Wisconsin Ave, Tieton, WA 98947-9802 Ph: (509) 673-0044 |
Mr. Kevin Barry Fitzgerald, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 915 Wisconsin Ave, Tieton, WA 98947 Phone: 509-673-0044 Fax: 509-673-0054 |