Individual
KENDRA BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP, AGPCNP, RN
Contact information
Practice address
101 COURT ST STE 8, PLYMOUTH, MA 02360-8718
(508) 732-7327
Mailing address
36 SAXTON ST UNIT 2, BOSTON, MA 02125-1439
(781) 264-4753
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2292034
MA
363LA2200X
Adult Health Nurse Practitioner
2292034
MA
363LG0600X
Gerontology Nurse Practitioner
2292034
MA
363LW0102X
Women's Health Nurse Practitioner
2292034
MA
Other
Enumeration date
09/24/2015
Last updated
10/01/2018
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