Broussard, Nicholas Paul

Broussard, Nicholas Paul is an sole proprietor health care provider with primary practice located at 5113 La Premiere Dr , Maurice LA 70555-3764. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Broussard, Nicholas Paul can be contacted via phone (337) 278-0037.

Contact Information

Primary practice address
5113 La Premiere Dr Maurice LA 70555-3764
Phone: (337) 278-0037
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X RN108764 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP05366 Louisiana

Profile Details

NPI number 1578755104
LBN Legal business name Broussard, Nicholas Paul
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2007
Last updated Oct 9th, 2015 - about 9 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 1578755104 NPPES
Louisiana MEDICAID 1315397

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