NPI 1962847822

Staci Broughton

Practitioner Surgical Assistant Broken Arrow, OK

Practice location

Address: 5101 N 34th St, Broken Arrow, OK 74014-1710
Phone: (918) 605-6796
Mailing address: PO Box 618, Coppell, TX 75019-0618

Registered specialties (2)

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X Licence 145868 (OK)

Other Specialist/Technologist, Other providers in Oklahoma →

Surgical Technologist

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZS0410X Licence 117099 (OK)

Registry record

NPI: 1962847822
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 May 2013
Record last updated: 15 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.