Healthcare Provider Details

I. General information

NPI: 1770377616
Provider Name (Legal Business Name): BRITTANY HEBERT BROUSSARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2429
US

IV. Provider business mailing address

4012 E ST
METAIRIE LA
70001-3662
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-3925
  • Fax:
Mailing address:
  • Phone: 504-235-1341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236831
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number147008
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: