Jessica Clare Broussard, MS, RDN
Individual provider Active NPI Registered Dietitian · Thorsby, AL
NPI 1134739832 · NPPES record last updated Aug 6, 2020
Key facts
- NPI
- 1134739832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 1297 Indiana Ave
Thorsby, AL 35171-8149 - Phone
- (205) 646-0431
- NPI assigned
- Aug 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
1297 Indiana Ave
Thorsby, AL 35171-8149
Mailing address
1297 Indiana Ave
Thorsby, AL 35171-8149
Phone (205) 646-0431
Other providers in Thorsby, AL
- Alabama Family Resource Center, PC
- Frances A Breslin
- Josephine Brown
- Cenrtal Alabama Medical Associates
- Chilton Family Medicine, P.C.
- Clanton Hospital LLC
- G Teal Dick
All providers in Thorsby, AL · Registered Dietitian in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.