Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHELLE D BROUSSARD, PHD, RDN, LD
Active Sole ProprietorRegistered Dietitian · ELLENWOOD, GA
Registration Details
- NPI Number
- 1689551053
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 18, 2025 (0.71924718796414 yrs)
- Last Updated
- Aug 18, 2025
- Licenses
-
LD002261 (GA)LD002261 (GA)LD00261 (GA)LD002261 (GA)LD002261 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4300 WARD BLUFF DRELLENWOOD, GA, 302941783Browse GA providers · Browse ZIP 30294
- Phone
- 4042162067
- Primary Specialty
-
Registered Dietitian
133V00000X
- Additional Specialty
- 132700000X
- Additional Specialty
- Renal Nutrition
- Additional Specialty
- Community Health Center
- Additional Specialty
- Registered Dietitian
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.