Provider Demographics
NPI:1992589485
Name:BRODBECK, CHERISH RACHELLE (MSN, RNC-OB, EMT-LP)
Entity type:Individual
Prefix:
First Name:CHERISH
Middle Name:RACHELLE
Last Name:BRODBECK
Suffix:
Gender:F
Credentials:MSN, RNC-OB, EMT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12111 CR 2150
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79404-8316
Mailing Address - Country:US
Mailing Address - Phone:972-965-6973
Mailing Address - Fax:
Practice Address - Street 1:12111 CR 2150
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79404-8316
Practice Address - Country:US
Practice Address - Phone:972-965-6973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710353163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight