Most Relevant Information
Provider Data
| NPI Number: | 1003374620 |
| Provider Name: | JESSICA LYNN BROUSSE NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 203935 |
Most Important Dates
| Enumeration Date: | 03/04/2019 |
| Last Updated: | 01/22/2021 |
Provider Practice Location
5000 HENNESSY BLVD
BATON ROUGE
LA
708084375
Practice Location Phone/Fax
| Phone: | 2257654050 |
| Fax: | 2257654046 |
Provider Mailing Location
5000 HENNESSY BLVD
BATON ROUGE
LA
70808
Provider Mailing Phone/Fax
| Phone: | 2257654050 |
| Fax: | 2257654046 |