NPI 1134739832 · live from the CMS NPI Registry
Jessica Clare Broussard, MS, RDN
Dietitian, Registered in Thorsby, AL. National Provider Identifier 1134739832, active.
NPI record
| NPI | 1134739832 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1297 Indiana Ave, Thorsby, AL 35171 |
| Practice phone | 205-646-0431 |
| Enumerated | August 6, 2020 |
| Last updated | August 6, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.