NPI Profile for LAURA BROUSSARD in ROYAL CITY, WA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1174632954 |
|
| Status | Active | |
| Credentials | APRN (Advanced Practice Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 08/29/2006 | |
| Last updated | 06/19/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LAURA BROUSSARD
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