Mary Jo Broussard
Nurse Practitioner in New Orleans, LA. Individual provider (NPI-1).
NPI number1285844571
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1285844571
- Entity type
- Individual (NPI-1)
- Name
- Mary Jo Broussard
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 23, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 046359-3340 | LA | Yes |
Practice location
1541 Tulane AveNew Orleans, LA 70112-2821
Phone 504-903-1301
Mailing address
1541 Tulane AveNew Orleans, LA 70112-2821
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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