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CINDERELLA MARIE BROUSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
208 W GLORIA SWITCH RD, LAFAYETTE, LA 70507-3409
(337) 565-7026
(855) 832-5335
Mailing address
PO BOX 913, CARENCRO, LA 70520-0913
(337) 565-7026
(855) 832-5335

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
093861
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
09099
LA

Other

Enumeration date
12/27/2007
Last updated
01/11/2020
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