Individual
KALI A BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9610 MAURICE AVE, MAURICE, LA 70555-3255
(337) 470-3131
(337) 470-3315
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(337) 470-3131
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
338039
LA
208000000X
Pediatrics Physician
35.139496
OH
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
35.139496
OH
2080P0208X
Pediatric Infectious Diseases Physician
Primary
338039
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0468063
—
OH
Enumeration date
03/27/2017
Last updated
07/24/2023
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