Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Broadway Family Clinic LLC

Organization Family Nurse Practitioner · NPI 1427566694

Broadway Family Clinic LLC is a Family Nurse Practitioner in Bloomfield, Missouri. Works from 2 locations. Licensed in Missouri.

Licensed in
MO
In the registry since
2018
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

612 State Highway 25 S
Bloomfield, MO 63825-9566
Phone: (573) 803-3995
Fax: (573) 803-5222
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 714 Broadway St, Cape Girardeau, MO 63701 — (573) 803-3995

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2014044250 (MO)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 126560 (MO)

Record details

NPI number1427566694
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Melissa Jarrell — Office/Billing Supervisor · (573) 568-7377
NPI enumeratedJanuary 22, 2018
Last updated in NPPESAugust 8, 2023
Certification dateAugust 7, 2023
Mailing address612 Hwy 25 South, Bloomfield, MO 63825-9566

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