Broussard, Paul W

Broussard, Paul W is an individual health care provider with primary practice located at 600 N Lewis St , New Iberia LA 70560. 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, Paul W can be contacted via phone (337) 365-3168.

Contact Information

Primary practice address
600 N Lewis St New Iberia LA 70560
Phone: (337) 365-3168
Fax: (337) 369-3536
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 037524 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA-01145 New Mexico

Profile Details

NPI number 1609962612
LBN Legal business name Broussard, Paul W
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Oct 24th, 2017 - about 8 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 1609962612 NPPES
Louisiana MEDICAID 1696609

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