Desiree Brouillette, CFM03594

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

License

CFM03594 Issued in LA

Practice address

78A Versailles Blvd
Alexandria, LA 71303-3960

Phone

(318) 619-7772

Fax

(318) 619-1101

NPI assigned

Apr 16, 2026

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

State licenses

Practice roles

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

• Apothecary Pharmacy, Inc

  • Community/Retail Pharmacy
  • Alexandria, LA
  • NPI 1922017508
  NPD (past)
• Rays Pharmacy 2 LLC

  • Community/Retail Pharmacy
  • Pineville, LA
  • NPI 1033508544
  NPD (past)

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

{
    "created_epoch": "1776297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1962346262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78A VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033960",
            "telephone_number": "318-619-7772",
            "fax_number": "318-619-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78A VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033960",
            "telephone_number": "318-619-7772",
            "fax_number": "318-619-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "DESIREE",
        "credential": "CFM03594",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "",
            "desc": "Mastectomy Fitter",
            "state": "LA",
            "license": "CFM03594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookshire Grocery Company
• Daisha Broomfield
• Korey Elise Brossett
• Sabrina Brossett
• Benjamin Patrick Brouillette
• Melissa Ann Brouillette
• Blaine Mark Broussard, M.D.
• James Brian Broussard, P.A.
• Kallyn Jones Broussard, NP
• Karissa Broussard

• Mastectomy Fitter in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Mastectomy Fitter in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.