Brenda S Broussard, CNM
Advanced Practice Midwife in Baton Rouge, LA. Individual provider (NPI-1).
NPI number1982886180
StatusActive
Last updated in NPPESMar 17, 2011
Details
- NPI
- 1982886180
- Entity type
- Individual (NPI-1)
- Name
- Brenda S Broussard
- Credential
- CNM
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 29, 2007
- Last updated
- Mar 17, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | AP01118 | LA | Yes |
| 367A00000X | Advanced Practice Midwife | R860596 | MS | |
| 367A00000X | Advanced Practice Midwife | RN091369 | LA |
Other names
- Brenda K. Shantz (Former Name)
Practice location
16777 Medical Center DrBaton Rouge, LA 70816-3254
Phone 225-754-3278
Mailing address
16777 Medical Center DrBaton Rouge, LA 70816-3254
Phone 225-754-3278
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