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Contact Information

HOLLI J BROUSSEAU, NURSE PRACTITIONER
825 CHALKSTONE AVE
PROVIDENCE, RI02908-4728
 Phone: 401-456-2000
 Fax: 401-861-9596
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for HOLLI J BROUSSEAU · (Female)

NPI # 1225434558
Status Active
Credentials NURSE PRACTITIONER
Entity Individual
Enumeration date 11/13/2014
Last updated 11/12/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • RI License # 37937
  • RI License # APRN01223
Hospital affiliation(s)
  • MIRIAM HOSPITAL - (Acute Care)
    164 SUMMIT AVENUE
    PROVIDENCE, RI 02906
  • ST JOSEPH HEALTH SERVICES OF RI - (Acute Care)
    200 HIGH SERVICE AVENUE
    NORTH PROVIDENCE, RI 02904
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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