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Contact Information

JAMILIA L BROUSSARD, MSN RN FNP-BC WCC
1001 12TH AVE NW
ARDMORE, OK73401-5712
 Phone: 580-220-6290
 Fax: 580-220-6215
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JAMILIA L BROUSSARD · (Female)

NPI Number 1184122145
Status Active
Credentials MSN RN FNP-BC WCC
Entity Individual
Enumeration date 01/24/2018
Last updated 08/03/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 821209
  • TX License # AP136689
Hospital affiliation(s)
  • MEDICAL CITY DALLAS HOSPITAL - (Acute Care)
    7777 FOREST LANE
    DALLAS, TX 75230
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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