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

Latricia Broaddus

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1003383688

Latricia Broaddus is a Nurse Practitioner in Aylett, Virginia. Qualified in 2021, 5 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2018
Specialties on file
2

Practice location Address checks out

5833 Richmond Tappahannock Hwy Ste 106B
Aylett, VA 23009-3007
Phone: (042) 230-0298
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 0024181570 (VA)
In Home Supportive Care Agency Taxonomy 253Z00000X

Record details

NPI number1003383688
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 31, 2018
Last updated in NPPESMarch 6, 2024
Certification dateMarch 6, 2024
Mailing addressPo Box 13, Saint Stephens Church, VA 23148-0013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Aylett