Individual provider · Type 1 NPI
Jamilia Lashawn Broussard, MSN RN FNP-BC WCC
Family Nurse Practitioner · Ardmore, OK
NPI number
1184122145
Active
Practice location
1001 12th Ave NW
Ardmore, OK 73401-5712
Fax (580) 220-6215
Mailing address
PO Box 678219
Dallas, TX 75267-8219
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 821209 (TX) |
| Family Nurse Practitioner Primary | 363LF0000X | AP136689 (TX) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1184122145
Jamilia Lashawn Broussard, MSN RN FNP-BC WCC's National Provider Identifier is 1184122145, issued on Jan 24, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Ardmore, OK. The record was last updated on Aug 3, 2021.