Healthcare Provider Details

I. General information

NPI: 1932393105
Provider Name (Legal Business Name): JULIA RODICA BROUSSARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA RODICA ANDERSEN MD

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3000
  • Fax:
Mailing address:
  • Phone: 816-234-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number04-31989
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number2006019744
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: