Individual
BRENDA S BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
16777 MEDICAL CENTER DR, BATON ROUGE, LA 70816-3254
(225) 754-3278
Mailing address
16777 MEDICAL CENTER DR, BATON ROUGE, LA 70816-3254
(225) 754-3278
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP01118
LA
367A00000X
Advanced Practice Midwife
R860596
MS
367A00000X
Advanced Practice Midwife
RN091369
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04970861
—
MS
05
—
2125176
—
LA
Enumeration date
11/29/2007
Last updated
03/17/2011
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