Susan Lee Broussard, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN107720-AP06410 Issued in LA

Practice address

345 Doucet Rd Ste 233
Lafayette, LA 70503-3490

Phone

(337) 257-5157

NPI assigned

Mar 9, 2011

Last updated

Nov 18, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HBAHCD

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.

• Sunshine Pediatric and Family Clinic LLC

  • Rural Health Clinic/Center
  • Breaux Bridge, LA
  • NPI 1619618964
  NPD (past)

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1740588003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 DOUCET RD STE 233",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033490",
            "telephone_number": "337-257-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 DOUCET RD STE 233",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033490",
            "telephone_number": "337-257-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP06410",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "RN107720-AP06410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shameeca Broussard
• Shane T Broussard, P.A.
• Sharronda Helena Broussard
• Shelley Broussard, RN,BSN,IBCLC
• Stephanie Ellen Broussard, M.S., BCBA, LBA
• Broussards Pharmacy and Wellness
• Brown Counseling & Consulting, LLC
• Terria Denise Brown-Auzenne, FNP-C
• Alexis Manning Brown, FNP
• Angela Jean Brown

• Pediatric Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.