| Doctor Name: | AIMEE C BROUSSARD |
| NPI Number: | 1710209044 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | RN094687-AP06057 |
| Business Practice Address: | 805 Albertson Pkwy Ste A Broussard, LA - 705184350 |
| Business Phone Number: | 3373304730 |
| Business Fax Number: | 3373304732 |
| Mailing Address: | P O Box 1317, BROUSSARD |
| State: | LA |
| Postal Code: | 705181317 |
| Phone Number: | 3373304730 |
| Fax Number: | 3373304732 |
| NPI Enumeration Date: | 03/01/2010 |
| NPI Last Update Date: | 01/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | RN094687-AP06057 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |