NPI 1962628156 · live from the CMS NPI Registry
Brenda A Broussard, RD, CDE, BC-ADM
Dietitian, Registered, Nutrition, Metabolic in Albuquerque, NM. National Provider Identifier 1962628156, active.
NPI record
| NPI | 1962628156 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered, Nutrition, Metabolic 133VN1006X |
| Practice location | Presbyterian Family Practice Medical Group, 3901 Atrisco, Albuquerque, NM 87120 |
| Practice phone | 505-462-7575 |
| Mailing address | 18 Berm St Nw, Albuquerque, NM 87120 |
| Enumerated | April 17, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered, Nutrition, Metabolic primary | 133VN1006X | 036 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.