Individual
MS. BRENDA A BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE, BC-ADM
Contact information
Practice address
PRESBYTERIAN FAMILY PRACTICE MEDICAL GROUP, 3901 ATRISCO, ALBUQUERQUE, NM 87120
(505) 462-7575
Mailing address
18 BERM ST NW, ALBUQUERQUE, NM 87120-1822
(505) 792-0065
(505) 792-0488
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
036
NM
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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