Broussard, Brenda S
Broussard, Brenda S is an individual health care provider with primary practice located at 16777 Medical Center Dr , Baton Rouge LA 70816-3254. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Broussard, Brenda S can be contacted via phone (225) 754-3278.Contact Information
Primary practice address
16777 Medical Center Dr
Baton Rouge LA 70816-3254
Phone: (225) 754-3278
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | R860596 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | AP01118 | Louisiana |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | RN091369 | Louisiana |
Profile Details
| NPI number | 1982886180 |
|---|---|
| LBN Legal business name | Broussard, Brenda S |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2007 |
| Last updated | Mar 17th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982886180 | NPPES |
| Mississippi | MEDICAID | 04970861 | |
| Mississippi | MEDICAID | 2125176 |
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