MARY JO BROUSSARD (NPI# 1285844571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285844571 |
| Entity Type | Individual |
| Full Name | MARY JO BROUSSARD |
| Practice Address |
1541 Tulane Ave New Orleans LA 70112-2821 |
| Practice Telephone | 5049031301 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 046359-3340 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | STATE BOARD NURSING | 046359-3340 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801227210 | Mary Elizabeth Broussard | Occupational Therapist | 2655 N. Causeway Blvd Suite D, Integrative Touch Pediatric Occupational Therapy, Mandeville, LA 70471 | 2013-12-11 |
| 1386837953 | Mary Elizabeth Broussard | Occupational Therapist | 107 Briarmeadow Dr, Lafayette, LA 70508-7210 | 2007-08-27 |
| 1154892982 | Mary Ballard Broussard | Occupational Therapist | 704 Longmire Rd Ste 101, Conroe, TX 77304-1850 | 2018-12-05 |
| Street Address |
1541 TULANE AVE |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70112-2821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497737704 | Jane Ann Arcario | Nurse Anesthetist, Certified Registered | 1541 Tulane Ave, New Orleans, LA 70112-2821 | 2005-11-14 |
| 1750564928 | Willie John Joseph IIi | Anesthesiology | 1541 Tulane Ave, New Orleans, LA 70112-2821 | 2007-12-11 |
| 1104022011 | Shane C Landreaux | Nurse Practitioner | 1541 Tulane Ave, Rm 505, New Orleans, LA 70112-2821 | 2007-06-26 |
| 1346459567 | Deidra Lewis Pierre | Nurse Practitioner | 1541 Tulane Ave, New Orleans, LA 70112-2821 | 2007-05-22 |
| 1659593853 | Coletha Riley | Clinical Nurse Specialist | 1541 Tulane Ave, Rm 505, New Orleans, LA 70112-2821 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346867306 | Suayp Oygen | Student in an Organized Health Care Education/Training Program | 1430 Tulane Ave., #8545 Suite 7209, New Orleans, LA 70112 | 2020-06-25 |
| 1073132692 | Bianca Ngwe Ndeso Fomukong | Student in an Organized Health Care Education/Training Program | 450a South Claiborne, Room 521, New Orleans, LA 70112 | 2020-04-14 |
| 1184253510 | Arya Mohammad Reza Loghmani | Student in an Organized Health Care Education/Training Program | 1542 Tulane Avenue, Box T4m-2, New Orleans, LA 70112 | 2020-04-07 |
| 1447889365 | Kinnah Menta Hughes | Student in an Organized Health Care Education/Training Program | 1900 Gravier Street, New Orlens, LA 70112 | 2020-04-02 |
| 1396373924 | Carson Mills | Student in an Organized Health Care Education/Training Program | Tulane University School of Medicine, Dept of Surgery, 1430 Tulane Ave., Mail Code 8622, New Orleans, LA 70112 | 2020-03-30 |
| 1417585134 | Pate Duddleston | Student in an Organized Health Care Education/Training Program | 131 S. Robertson St., Ste. 1300 Mail Code 8047, New Orleans, LA 70112 | 2020-03-29 |
| 1467090084 | Camilla Henderson | Technician, Pathology | 1415 Tulane Hospital, New Orleans, LA 70112 | 2019-12-13 |
| 1942850615 | Shannon R. Bierma | Psychologist | 1542 Tulane Ave, Department of Psychiatry, New Orleans, LA 70112 | 2019-09-16 |
| 1326608035 | Julia Obehi Aigbogun | Student in an Organized Health Care Education/Training Program | Tulane Hospital and Clinics 1415 Tulane Avenue, New Orleans, LA 70112 | 2019-06-14 |
| 1477016970 | Nicole Marie Crozat | Student in an Organized Health Care Education/Training Program | Dept of Psych, 1542 Tulane Avenue, New Orleans, LA 70112 | 2019-04-11 |
| Find all providers in zip 70112 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497369706 | Karla Matthews | Nurse Practitioner | 3710 South Rochenblave St., New Orleans, LA 70125-1003 | 2020-09-03 |
| 1922626365 | Shanika Valcour-leduff | Nurse Practitioner | 535 S Galvez St., New Orleans, LA 70119 | 2020-07-13 |
| 1366947376 | Darlene Sentmore-labostrie | Nurse Practitioner | 9954 Lake Forest Blvd Ste 10, New Orleans, LA 70127-2647 | 2018-03-30 |
| 1194246686 | Sauntrice Oquin | Nurse Practitioner | 3433 Hamburg St, New Orleans, LA 70122-2308 | 2017-07-05 |
| 1275062101 | Geaux Medical Staffing | Nurse Practitioner | 3436 Magazine St # 8059, New Orleans, LA 70115-2413 | 2017-06-05 |
| 1699131961 | Mallory K Cantero | Nurse Practitioner | 2003 Tulane Ave, New Orleans, LA 70112-3500 | 2016-01-02 |
| 1366799975 | Lannie Cumbo Guidry | Nurse Practitioner | 6363 St. Charles Ave, New Orleans, LA 70118 | 2012-08-14 |
| 1003102021 | Elaine Alleman | Nurse Practitioner | 335 Audubon Blvd, New Orleans, LA 70125-4124 | 2011-06-28 |
| 1699076810 | Anne Dolores Troy | Nurse Practitioner | 1101 Calhoun St, New Orleans, LA 70118 | 2010-11-04 |
| 1588988828 | Wendy Carmen Simpson | Nurse Practitioner | 1100 Bourbon St, Ste 306, New Orleans, LA 70116-2710 | 2010-03-15 |
| Find all providers in NEW ORLEANS | ||||
| City | NEW ORLEANS |
| Zip Code | 70112 |
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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.