| Mr Nicholas Paul Broussard, CRNA | |
|
5113 La Premiere Dr, Maurice, LA 70555-3764 | |
| (337) 278-0037 | |
| Not Available |
| Full Name | Mr Nicholas Paul Broussard |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 18 Years |
| Location | 5113 La Premiere Dr, Maurice, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578755104 | NPI | - | NPPES |
| 1315397 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WC0200X | Registered Nurse - Critical Care Medicine | RN108764 (Louisiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP05366 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Abbeville General Hospital | Abbeville, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Youngs Professional Services Llc | 2163524992 | 218 |
| Abbeville General Hospital | 5395641955 | 9 |
| Entity Name | Abbeville General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780616094 PECOS PAC ID: 5395641955 Enrollment ID: O20031212000345 |
| Entity Name | Youngs Professional Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922178599 PECOS PAC ID: 2163524992 Enrollment ID: O20070226000608 |
| Entity Name | Diversified Professionals, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700923992 PECOS PAC ID: 0446356463 Enrollment ID: O20070507000647 |
| Entity Name | Zephyr Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891087458 PECOS PAC ID: 1658559125 Enrollment ID: O20110705000180 |
| Entity Name | Precision Anesthesia Of Lafayette Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285117879 PECOS PAC ID: 2860746351 Enrollment ID: O20181120001221 |
| Entity Name | Jefferson Anesthesia Consultants |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639816374 PECOS PAC ID: 8820470057 Enrollment ID: O20220803003439 |
| Entity Name | Dpi Of Louisiana Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144083387 PECOS PAC ID: 1456886365 Enrollment ID: O20241130000133 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Nicholas Paul Broussard, CRNA 5113 La Premiere Dr, Maurice, LA 70555-3764 Ph: (337) 278-0037 | Mr Nicholas Paul Broussard, CRNA 5113 La Premiere Dr, Maurice, LA 70555-3764 Ph: (337) 278-0037 |