MRS. JAMILIA LASHAWN BROUSSARD (NPI# 1184122145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184122145 |
| Entity Type | Individual |
| Full Name | MRS. JAMILIA LASHAWN BROUSSARD |
| Credential | MSN RN FNP-BC WCC |
| Practice Address |
1001 12th Ave Nw Ardmore OK 73401-5712 |
| Practice Telephone | 5802206290 |
| Practice Fax Number | 5802206215 |
| Mailing Telephone | 5802206290 |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2020-05-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
821209 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1001 12TH AVE NW |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-5712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902218548 | Tabathya Lane | Nurse Practitioner | 1001 12th Ave Nw, Suite 100, Ardmore, OK 73401 | 2014-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457981177 | Richard Evers | Nurse Practitioner | 152 Ruidosa St, Ardmore, OK 73401-7231 | 2020-01-22 |
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1487213302 | Rachel Diane Wrany | Nurse Practitioner | 1675 12th Ave Nw, Ardmore, OK 73401-1283 | 2019-06-13 |
| 1871067199 | Jacqueline Frances Miller | Nurse Practitioner | 148 Sierra St, Ardmore, OK 73401-7275 | 2019-01-21 |
| 1194120832 | Lindsay Coffman | Nurse Practitioner | 610 West Lancaster Avenue, Ardmore, PA 19003 | 2014-10-23 |
| 1902218548 | Tabathya Lane | Nurse Practitioner | 1001 12th Ave Nw, Suite 100, Ardmore, OK 73401 | 2014-06-02 |
| 1700208618 | Amg-hillside LLC | Nurse Practitioner | 26032 Main St, Ardmore, TN 38449-3375 | 2014-01-11 |
| 1457571309 | Patricia Yanda Rush | Nurse Practitioner | 802 16th Ave Nw, Ardmore, OK 73401-1818 | 2007-04-25 |
| 1962446369 | Gary O Lawson | Nurse Practitioner | 26642 Main Street, Ardmore, AL 35739-7624 | 2006-06-15 |
| 1932165768 | Frelyn G Loughridge | Nurse Practitioner | 1025 15th Ave Nw, Ardmore, OK 73401-1810 | 2006-04-21 |
| Find all providers in ARDMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.