Alicia Broussard
Hospitalist in Bismarck, ND. Individual provider (NPI-1).
NPI number1295187888
StatusActive
Last updated in NPPESOct 11, 2021
Details
- NPI
- 1295187888
- Entity type
- Individual (NPI-1)
- Name
- Alicia Broussard
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2016
- Certification date
- Oct 11, 2021
- Last updated
- Oct 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | 17317 | ND | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Other names
- Alicia Juljenjai (Former Name)
Practice location
222 N 7th StBismarck, ND 58501-4436
Phone 701-323-5422
Mailing address
Po Box 5074Sioux Falls, SD 57117-5074
Other practice locations
1301 S Crismon Rd
Mesa, AZ 85209
Mesa, AZ 85209
Phone 480-373-2370
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