Aimee Vidrine Broussard, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN074755 Issued in LA

Practice address

128 Curran LN
Lafayette, LA 70506-7222

Phone

(337) 991-0101

Fax

(855) 724-6797

NPI assigned

Jan 8, 2021

Last updated

Jan 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Compounding Pharmacies of Louisiana, Inc.

  dba Professional Arts Pharmacy

  • Mail Order Pharmacy
  • Lafayette, LA
  • NPI 1104438084
  NPD
• Compounding Pharmacies of Louisiana, Inc.

  dba Professional Arts Pharmacy

  • Community/Retail Pharmacy
  • Lafayette, LA
  • NPI 1194890731
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1083202691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 CURRAN LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067222",
            "telephone_number": "337-991-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 CURRAN LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067222",
            "telephone_number": "337-991-0101",
            "fax_number": "855-724-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "AIMEE",
        "middle_name": "VIDRINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN074755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth P Brooksher, CRNA
• Brookshire Grocery Company (Super 1 Pharmacy)
• Brookshire Grocery Company (Super 1 Pharmacy)
• Broussard Speech Therapy, Inc. (Speech Language Specialists, Inc.)
• Aiesha Danelle Broussard
• Alexis Broussard, LMSW
• Amanda Benson Broussard, LMSW
• Angie B. Broussard, MS, CCC - SLP
• April Broussard, CRNA
• Armanee Broussard, MSW, LCSW

• Registered Nurse in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.