Healthcare Provider Details

I. General information

NPI: 1982528501
Provider Name (Legal Business Name): CYPRESS PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 FLAGG PL STE B
LAFAYETTE LA
70508-7025
US

IV. Provider business mailing address

113 FLAGG PL STE B
LAFAYETTE LA
70508-7025
US

V. Phone/Fax

Practice location:
  • Phone: 337-247-7282
  • Fax:
Mailing address:
  • Phone: 337-247-7282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMIE RYAN BROUSSARD II
Title or Position: OWNER/NURSE PRACTITIONER
Credential: APRN-CNP
Phone: 318-664-0822