Individual
STEPHANIE L BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
6410 FANNIN ST, 500, HOUSTON, TX 77030-3000
(832) 325-7111
(713) 512-2227
Mailing address
6431 FANNIN ST STE 3.242, HOUSTON, TX 77030-1501
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
670437
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189514601
—
TX
01
—
189514602
CSHCN
TX
01
—
8Y3004
BCBS
TX
Enumeration date
06/21/2007
Last updated
02/10/2022
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