IndividualActive
Staci Broughton
NPI 1962847822 · Surgical Assistant · Broken Arrow, OK
Provider details
- NPI number
- 1962847822
- Entity type
- Individual
- Primary specialty
- Surgical AssistantTechnologists, Technicians & Other Technical Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 117099 (OK)
Mailing address
Po Box 618
Coppell, TX 75019-0618
Registry dates
- Enumerated
- 2013-05-06
- Last updated
- 2013-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.