Individual
MR. ANDREA BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
—
—
172A00000X
Driver
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104736701
—
MS
Enumeration date
01/09/2017
Last updated
02/01/2019
Update your record
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