Dr. Nicole Stack Broerman
MD | Pediatrics | Female
Dr. Nicole Stack Broerman, MD is a Hinesville, Georgia based Pediatric doctor with medical specialization in
General Pediatrics. Dr. Nicole Stack Broerman is also known as
Nicole Marie Stack.
Current practice location of Dr. Nicole Stack Broerman is
462 Elma G Miles Pkwy, Hinesville, Georgia - 31313-4000. She can be contacted on phone at
912-369-9400 and fax number 912-877-9438.
Dr. Nicole Stack Broerman is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Nicole Stack Broerman is
1013902741 which was assigned by NPPES on 19 Sep, 2005 and it was last updated on 17 Apr, 2018.
Dr. Nicole Stack Broerman license number is
47265 for Pediatrics (208000000X) in Georgia.
Dr. Nicole Stack Broerman is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Nicole Stack Broerman basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Nicole Stack Broerman |
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| Other Name : | Nicole Marie Stack |
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| Credential : | MD |
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| Gender : | Female |
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| Sole Proprietor : | Yes |
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Business Address:
Dr. Nicole Stack Broerman address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 462 Elma G Miles Pkwy
Hinesville, GA, 31313-4000
United States |
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| Phone Number : | 912-369-9400 |
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| Fax Number : | 912-877-9438 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1013902741 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 19 Sep, 2005 |
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| Last Updated On : | 17 Apr, 2018 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Nicole Stack Broerman are as mentioned. Primary taxonomy code for Dr. Nicole Stack Broerman, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 47265 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Nicole Stack Broerman such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| T74835 | MEDICAID | GA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 919
Hinesville, GA, 31310-0919
United States |
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| Phone Number : | 912-369-9400 |
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Business Location:
Patients can refer following map for directions to
Dr. Nicole Stack Broerman practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.