Individual provider · Type 1 NPI
Michelle D. Broussard, PhD, RDN, LD
Registered Dietitian · Ellenwood, GA
Practice location
4300 Ward Bluff Dr
Ellenwood, GA 30294-1783
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | LD002261 (GA) |
| Dietary Manager | 132700000X | LD002261 (GA) |
| Renal Nutrition Registered Dietitian | 133VN1005X | LD00261 (GA) |
| Community Health Clinic/Center | 261QC1500X | LD002261 (GA) |
| Registered Dietitian Primary | 133V00000X | LD002261 (GA) |
Registered Dietitian: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the…
About NPI 1689551053
Michelle D. Broussard, PhD, RDN, LD's National Provider Identifier is 1689551053, issued on Aug 18, 2025. The primary taxonomy on file is Registered Dietitian (133V00000X), and the practice location is in Ellenwood, GA. The record was last updated on Aug 18, 2025.