Kristin Brousseau, DO, PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

40799 Issued in CO

Legal business name

KRISTIN BROUSSEAU, DO, PC

Practice address

2501 Walnut St
Suite 108
Boulder, CO 80302-5751

Phone

(720) 223-7877

Fax

(888) 873-4912

NPI assigned

Apr 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kristin M Brousseau, D.O.

Title

President, Sole Proprietor

Phone

(720) 938-6720

Specialties & licenses 1

Addresses

Other names 1

• Boulder Neuropsychiatry Doing business as

Locations

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1104069335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 WALNUT ST",
            "address_2": "SUITE 108",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025751",
            "telephone_number": "720-223-7877",
            "fax_number": "888-873-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WALNUT ST",
            "address_2": "SUITE 108",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025751",
            "telephone_number": "720-223-7877",
            "fax_number": "888-873-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN BROUSSEAU, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-17",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "BROUSSEAU",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT, SOLE PROPRIETOR",
        "authorized_official_telephone_number": "720-938-6720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "40799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder Neuropsychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ken Kreidl, M.D.
• Ming-Yi Ryn W Kreidl, MD
• Stefanie L Krenz, MD
• Bonnie S Krim, RN
• Katherine Shaw Kripke, LCSW
• Carly Mae Kroening
• Lara M Kroepsch, PA
• Krueger Optometry LLC
• Jennifer Lynn Krueger, OD
• Wendy Leeoiler Krueger, LSW

• Psychiatry Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.