JESSIRAE BROUSSARD (NPI# 1326452962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326452962 |
| Entity Type | Individual |
| Full Name | JESSIRAE BROUSSARD |
| Credential | AA |
| Practice Address |
2525 Glenn Hendren Dr Anesthesia Dept Liberty MO 64068-9625 |
| Mailing Address |
Po Box 804408 Kansas City MO 64180-4408 |
| Practice Telephone | 8167927126 |
| Practice Fax Number | 8167927196 |
| Mailing Telephone | 9136424900 |
| Mailing Fax Number | 9133810979 |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 2014018078 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2525 GLENN HENDREN DR ANESTHESIA DEPT |
| City | LIBERTY |
| State | MO |
| Zip Code | 64068-9625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548265945 | Tyron A Townsend | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2005-06-14 |
| 1841811759 | Sharla Sue Leon | Speech-Language Pathologist | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2020-05-01 |
| 1437793924 | Jordan Colyer | Registered Nurse | 2525 Glenn Hendren Dr, Liberty, MO 64068-9600 | 2019-10-29 |
| 1922667054 | Abdulrahman B Derbas | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2019-06-12 |
| 1568940880 | William Jackson Redmond | Specialist/Technologist | 2525 Glenn Hendren Dr, Liberty, MO 64068-9600 | 2018-07-30 |
| 1336646736 | Liberty Hospital Emergency Medicine Physicians, LLC | Emergency Medicine | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2018-04-11 |
| 1235673872 | Deer Valley Emergency Physicians LLC | Physician Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2016-12-16 |
| 1760925002 | Kelsey Koehler | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2016-11-18 |
| 1679926455 | Michael Scott Beeler | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Anesthetic Dept, Liberty, MO 64068-9625 | 2016-07-18 |
| 1013369727 | Laura M Lee | Nurse Anesthetist, Certified Registered | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2016-07-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
| 1063935062 | Jennifer Nichole Gibson | Nurse Practitioner | Liberty Hospital 2525 Glen Hendren Dr, Liberty, MO 64068 | 2017-07-21 |
| 1598288755 | Lhlc Operations, LLC | Skilled Nursing Facility | 2609 Glenn Hendren Dr Ste G100, Liberty, MO 64068 | 2017-07-19 |
| 1023438371 | Sarah E Ehlers | Social Worker | 1170 W. Kansas Ave, Bldg 10, Liberty, MO 64068 | 2014-04-24 |
| 1629498563 | Kelli Hedgpeth | Physical Therapy Assistant | 3980 South Jackson Dr, Independence, MO 64068 | 2014-04-18 |
| 1639593965 | Klein Dental Group LLC | Clinic/Center | 12 Westwoods Dr, Liberty, MO 64068 | 2014-02-06 |
| 1124457239 | Sarah Ehlers, Lcsw LLC | Social Worker | 1170 W Kansas Ave, Bldg 10, Liberty, MO 64068 | 2013-11-08 |
| 1134561558 | Holly Hemphill | Marriage & Family Therapist | 117 N. Water Street, Liberty, MO 64068 | 2013-07-26 |
| 1093157133 | Tina Wilma Sanborn | Marriage & Family Therapist | 1170 W. Kansas St., Liberty, MO 64068 | 2013-07-17 |
| 1609215441 | Timothy Adam Lynch | Marriage & Family Therapist | 1170 West Kansas Ave., Liberty, MO 64068 | 2013-06-14 |
| Find all providers in zip 64068 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548265945 | Tyron A Townsend | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2005-06-14 |
| 1922667054 | Abdulrahman B Derbas | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2019-06-12 |
| 1760925002 | Kelsey Koehler | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2016-11-18 |
| 1679926455 | Michael Scott Beeler | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Anesthetic Dept, Liberty, MO 64068-9625 | 2016-07-18 |
| 1457700221 | Meghan Marie Batchelor | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2016-06-12 |
| 1912292475 | Joshua Richard Leet | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Anesthesia Dept, Liberty, MO 64068-9625 | 2011-06-13 |
| 1154579415 | Trent Andrew Platz | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Anesthesia Dept, Liberty, MO 64068-9625 | 2008-08-28 |
| 1144485533 | Mary Jeanne Roberts | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2008-07-24 |
| 1962602524 | Lance Crawford Carter | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2007-07-23 |
| 1124191143 | Melanie J Guthrie | Anesthesiologist Assistant | 2525 Glenn Hendren Dr, Liberty, MO 64068-9625 | 2006-11-16 |
| Find all providers in LIBERTY | ||||
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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.