MS. BRENDA A BROUSSARD (NPI# 1962628156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962628156 |
| Entity Type | Individual |
| Full Name | MS. BRENDA A BROUSSARD |
| Credential | RD, CDE, BC-ADM |
| Practice Address |
Presbyterian Family Practice Medical Group 3901 Atrisco Albuquerque NM 87120 |
| Mailing Address |
18 Berm St Nw Albuquerque NM 87120-1822 |
| Practice Telephone | 5054627575 |
| Mailing Telephone | 5057920065 |
| Mailing Fax Number | 5057920488 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
036 | NM | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427611904 | Brenda Broussard | Registered Nurse | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2019-04-19 |
| 1982886180 | Brenda S Broussard | Advanced Practice Midwife | 16777 Medical Center Dr, Baton Rouge, LA 70816-3254 | 2007-11-29 |
| Street Address |
PRESBYTERIAN FAMILY PRACTICE MEDICAL GROUP 3901 ATRISCO |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971919 | Erica Denise Ortiz | Social Worker | 6212 Casa Blanca Dr Nw, Albuquerque, NM 87120 | 2020-10-27 |
| 1770133589 | Laura Lee Smith | Technician | 5112 Vista De Luz Nw, Albuquerque, NM 87120 | 2019-09-13 |
| 1285282715 | Aiden Charles Martinez | Case Manager/Care Coordinator | 6704 Nueva Pierda Street Nw, Albuquerque, NM 87120 | 2019-08-28 |
| 1831753508 | Jennifer Lydia Castro | Nurse Practitioner | 8428 Hawk Eye Rd Nw, Albuquerque, NM 87120 | 2019-04-27 |
| 1518425065 | Jean Louise Ramsey | Counselor | Office Alternatives/ The Center for Life Changes, 6300 Riverside Plaza Nw, Suite 100, Albuquerque, NM 87120 | 2019-03-04 |
| 1689147365 | Stairway Recovery, LLC | Family Medicine | 6300 Riverside Plaza Ln Nw Ste 118 #96523, Albuquerque, NM 87120 | 2019-01-06 |
| 1417443276 | Kyle Thomas Lantz | Dentist | 2800-a Coors Blvd Nw, Albuquerque, NM 87120 | 2018-07-05 |
| 1437669736 | Beatrice Ottomanelli | Day Training/Habilitation Specialist | 9180 Coors Blvd. Nw, Apt. 3307, Albuquerque, NM 87120 | 2017-10-02 |
| 1740705516 | Alianza Home Care, LLC | Home Health | 8307 Casa Negra Ct Nw, Albuquerque, NM 87120 | 2017-08-13 |
| 1366963399 | Jamie Farris | Registered Nurse | 8201 Golf Course Road Northwest, Suite D3 #121, Albuquerque, NM 87120 | 2017-06-29 |
| Find all providers in zip 87120 | ||||
| Taxonomy Code | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417295916 | Teresa J Anderson | Dietitian, Registered | 6701 Jefferson St Ne, Albuquerque, NM 87109-4318 | 2013-01-18 |
| 1205098837 | Colleen M Seeley | Dietitian, Registered | 1719 Girard Blvd Ne, Albuquerque, NM 87106-1718 | 2008-06-25 |
| 1508893231 | Elaine S. Reyes | Dietitian, Registered | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2006-06-27 |
| City | ALBUQUERQUE |
| Zip Code | 87120 |
Please comment or provide details below to improve the information on MS. BRENDA A BROUSSARD.
| 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.