Broussard, Kimberly Marie
Broussard, Kimberly Marie is an individual health care provider with primary practice located at 249 Corporate Dr , Houma LA 70360-2769. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Broussard, Kimberly Marie can be contacted via phone (985) 853-0900.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA.200597 | Louisiana |
Profile Details
| NPI number | 1508200577 |
|---|---|
| LBN Legal business name | Broussard, Kimberly Marie |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 22nd, 2013 |
| Last updated | Jul 20th, 2023 - about last year |
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 | 1508200577 | NPPES |
| Louisiana | MEDICAID | 2330438 | |
| Louisiana | MEDICAID | 01253212 |
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