Broussard, Kim P.

Broussard, Kim P. is an sole proprietor health care provider with primary practice located at 1101 S College Rd Suite 100, Lafayette LA 70503-3038. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Broussard, Kim P. can be contacted via phone (337) 233-8603.

Contact Information

Primary practice address
1101 S College Rd Suite 100 Lafayette LA 70503-3038
Phone: (337) 233-8603
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN037148/AP02026 Louisiana

Profile Details

NPI number 1578523718
LBN Legal business name Broussard, Kim P.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578523718 NPPES
Louisiana MEDICAID 1902764

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