Provider Demographics
NPI:1437703923
Name:BROYLES, JANICE A
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:A
Last Name:BROYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 PARK ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3353
Mailing Address - Country:US
Mailing Address - Phone:913-712-9680
Mailing Address - Fax:877-384-3106
Practice Address - Street 1:9100 PARK ST STE 100
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3353
Practice Address - Country:US
Practice Address - Phone:913-712-9680
Practice Address - Fax:877-384-3106
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79068363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily