NPI 1295066769 · live from the CMS NPI Registry
Mary Jane Broge, PNP
Nurse Practitioner, Pediatrics in Saint Louis, MO. National Provider Identifier 1295066769, active.
NPI record
| NPI | 1295066769 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1 Childrens Pl, Div Ped Cardiology, Saint Louis, MO 63110 |
| Practice phone | 314-454-6095 |
| Mailing address | Po Box 7412011, Chicago, IL 60674 |
| Enumerated | January 23, 2010 |
| Last updated | February 9, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 2004033032 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.