| Doctor Name: | DR. JAMIE BROUSSARD PACKMAN |
| NPI Number: | 1598094526 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 801077 |
| Business Practice Address: | 2300 Highway 365 Suite 330 Nederland, TX - 776276256 |
| Business Phone Number: | 4097275785 |
| Business Fax Number: | |
| Mailing Address: | 2700 Tyler Ave, NEDERLAND |
| State: | TX |
| Postal Code: | 776276315 |
| Phone Number: | 4097270501 |
| Fax Number: | |
| NPI Enumeration Date: | 12/22/2009 |
| NPI Last Update Date: | 12/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 801077 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |