Lucy Broaddus, MMS, PA-C, ATC.
Physician Assistant · O Fallon, IL
UnclaimedMMS, PA-C, ATC.NPI 1114299419
- Primary taxonomy
- 363A00000X
- Enumerated
- 2012-02-01
- Practice location
- O Fallon, IL
- Last NPPES update
- 2026-01-26
State licenses
- IL · Physician assistant · LICENSED PHYSICIAN ASSISTANTActivethrough 2028
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.