Individual
JENNIFER ALISON BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
211 GOOSE HOLLOW RD, REYNOLDS, GA 31076-3505
(478) 216-1110
Mailing address
211 GOOSE HOLLOW RD, REYNOLDS, GA 31076-3505
(478) 216-1110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN204586
GA
363LF0000X
Family Nurse Practitioner
Primary
RN204586
GA
Other
Enumeration date
07/05/2017
Last updated
10/15/2025
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