| Doctor Name: | DANIELLE MARIE DESORMEAUX BROUSSARD |
| NPI Number: | 1669827192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AGACNP |
| License Number: | AP08740 |
| Business Practice Address: | 105 Anzalone Dr Broussard, LA - 705184786 |
| Business Phone Number: | 3372573712 |
| Business Fax Number: | |
| Mailing Address: | 105 Anzalone Dr, BROUSSARD |
| State: | LA |
| Postal Code: | 705184786 |
| Phone Number: | 3372573712 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2016 |
| NPI Last Update Date: | 05/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | AP08740 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |