Individual
JESSICA LA GRECO BROUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N., F.N.P.-C.
Contact information
Practice address
1520 GAUSE BLVD, SLIDELL, LA 70458-2208
(985) 646-0945
(985) 643-8510
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0001
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06669
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1819417
—
LA
01
—
P01030618
RAILROAD MEDICARE PTAN
LA
Enumeration date
12/08/2011
Last updated
03/09/2018
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