Individual provider · Type 1 NPI
Kendra Broussard, NNP
Critical Care Neonatal Nurse Practitioner · Salt Lake City, UT
NPI number
1346616604
Active
Practice location
50 N Medical Dr, Nicu
Salt Lake City, UT 84132-0001
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | RN198466 (GA) |
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 8834868-4405 (UT) |
| Critical Care Neonatal Nurse Practitioner Primary | 363LN0005X | RN198466 (GA) |
Critical Care Neonatal Nurse Practitioner: Definition to come...
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About NPI 1346616604
Kendra Broussard, NNP's National Provider Identifier is 1346616604, issued on Aug 20, 2015. The primary taxonomy on file is Critical Care Neonatal Nurse Practitioner (363LN0005X), and the practice location is in Salt Lake City, UT. The record was last updated on Aug 4, 2022.