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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. NICHOLAS PAUL BROUSSARD, CRNA

Active Sole Proprietor

MR. NICHOLAS PAUL BROUSSARD, CRNA is a Certified Nurse Anesthetist (CRNA) healthcare provider located in MAURICE, Louisiana. NPI 1578755104 is currently active in the NPPES registry. Verify at CMS.

Certified Nurse Anesthetist (CRNA) · MAURICE, LA

Registration Details

NPI Number
1578755104
Provider Type
Individual
Gender
Male
NPI Issued
Aug 17, 2007 (19.030141090388 yrs)
Last Updated
Oct 9, 2015
Licenses
RN108764 (LA)
AP05366 (LA)
Sole Proprietor
Yes

Practice Information

Address
5113 LA PREMIERE DR
MAURICE, LA, 705553764
Browse LA providers · Browse ZIP 70555
Phone
3372780037
Primary Specialty
Certified Nurse Anesthetist (CRNA)
367500000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.