Provider Demographics
NPI:1528803970
Name:BROADNAX, YOLANDA DENISE (CRNP)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:DENISE
Last Name:BROADNAX
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801A S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-3011
Mailing Address - Country:US
Mailing Address - Phone:334-391-9889
Mailing Address - Fax:
Practice Address - Street 1:2344 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-2537
Practice Address - Country:US
Practice Address - Phone:409-898-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-095576363LW0102X
TX1169525363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health