Provider Demographics
NPI:1013218494
Name:BROUSSARD, ERIKA MAY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:MAY
Last Name:BROUSSARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 KINGMAN ST.
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006
Mailing Address - Country:US
Mailing Address - Phone:504-885-3737
Mailing Address - Fax:504-885-5507
Practice Address - Street 1:2905 KINGMAN ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6615
Practice Address - Country:US
Practice Address - Phone:504-885-3737
Practice Address - Fax:504-885-5507
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily