Kimberly Marie Broussard, PA
Physician Assistant in Houma, LA. Individual provider (NPI-1).
NPI number1508200577
StatusActive
Last updated in NPPESJul 20, 2023
Details
- NPI
- 1508200577
- Entity type
- Individual (NPI-1)
- Name
- Kimberly Marie Broussard
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 22, 2013
- Certification date
- Jul 20, 2023
- Last updated
- Jul 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA.200597 | LA | Yes |
Practice location
249 Corporate DrHouma, LA 70360-2769
Phone 985-853-0900
Mailing address
249 Corporate DrHouma, LA 70360-2769
Phone 985-853-0900
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All 21 Physician Assistant providers in Houma · All 2,171 providers in Houma
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