DR. CRAIG LOUIS BROUSSARD PHD APRN NPI 1235368556

NPI Information

NPI: 1235368556
Provider Name: DR. CRAIG LOUIS BROUSSARD, PHD, APRN
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Address:
3030 NORTH ST STE 450
BEAUMONT, TX
ZIP 77702
Phone: (409) 832-9600
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DR. Craig Louis Broussard, PHD, APRN is a gerontology nurse practitioner in Beaumont, TX. DR. Craig Louis Broussard, PHD, APRN NPI is 1235368556. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3030 NORTH ST STE 450
BEAUMONT, TX
ZIP 77702-434
Phone: (409) 832-9600
Fax: (409) 832-9610

The enumeration date for this NPI number is 7/8/2009 and was last updated on 7/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WM0705X	Registered Nurse	Medical-Surgical	250614	TEXAS	No
2	163WW0000X	Registered Nurse	Wound Care	250614	TEXAS	No
3	364S00000X	Clinical Nurse Specialist		250614	TEXAS	No
4	364SM0705X	Clinical Nurse Specialist	Medical-Surgical	250614	TEXAS	No
5	363LG0600X	Nurse Practitioner	Gerontology	250614	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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