Shelley Broussard, RN,BSN,IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

48443 Issued in LA

Practice address

4630 Ambassador Caffery Pkwy Ste 204
Lafayette, LA 70508-6949

Phone

(337) 470-5546

NPI assigned

Apr 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shelley Jones Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1124601026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 AMBASSADOR CAFFERY PKWY FL PAKWAY2",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086908",
            "telephone_number": "337-470-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY STE 204",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086949",
            "telephone_number": "337-470-5546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086902",
            "country_code": "US",
            "telephone_number": "337-470-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "SHELLEY",
        "credential": "RN,BSN,IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "LA",
            "license": "48443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "JONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard K. Broussard, M.D.
• Robyn Broussard, CIT #3466 LOUISIANA
• Shameeca Broussard
• Shane T Broussard, P.A.
• Sharronda Helena Broussard
• Stephanie Ellen Broussard, M.S., BCBA, LBA
• Susan Lee Broussard, APRN
• Broussards Pharmacy and Wellness
• Brown Counseling & Consulting, LLC
• Terria Denise Brown-Auzenne, FNP-C

• Lactation Consultant (Registered Nurse) in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Lactation Consultant (Registered Nurse) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.