Individual
TERESA LYNN BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 N ELM ST, KIMBALL, NE 69145-1008
(308) 235-5492
Mailing address
204 N ELM ST, KIMBALL, NE 69145-1008
(308) 235-5492
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
15769
NE
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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