Judd Tanner Broussard in Lafayette - Nurse Anesthetist, Certified Registered
Judd Tanner Broussard - NPI 1073612693
Judd Tanner Broussard is a Nurse Anesthetist, Certified Registered in Lafayette, Louisiana. Judd Tanner Broussard practices all healthcare services and medical treatments related to Nurse Anesthetist, Certified Registered. The NPI Number for Judd Tanner Broussard is 1073612693. The last update date is 2010-07-29.
Judd Tanner Broussard's current location address is 1103 Kaliste Saloom Rd, Lafayette, Louisiana. You can contact this provider via phone number 3379885646 and fax number 3379884298. The mailing address for Judd Tanner Broussard is 1103 Kaliste Saloom Rd, Lafayette, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Judd Tanner Broussard |
|---|---|
| Address | 1103 Kaliste Saloom Rd, Lafayette, Louisiana |
| Phone Number | 3379885646 |
| Fax Number | 3379884298 |
| Sole Proprietor | N |
| Credentials | CRNA |
NPI Number Detail
| NPI Number | 1073612693 |
|---|---|
| Provider Enumeration Date | 2006-09-21 |
| Last Updated Date | 2010-07-29 |
Provider Mailing Address Detail
| Address | 1103 Kaliste Saloom Rd |
|---|---|
| City | Lafayette |
| State | Louisiana (LA) |
| Post Code | 705085783 |
| Phone Number | 3379885646 |
| Fax Number | 3379884298 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Anesthetist, Certified Registered |
|---|---|
| Taxonomy | 367500000X |
| Licence No | AP04874 |
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Definition: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1581160 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Judd Tanner Broussard by the Centers for Medicare & Medicaid Services?
The Judd Tanner Broussard has been assigned the NPI (National Provider Identifier) 1073612693 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Judd Tanner Broussard?
The Judd Tanner Broussard is physically situated at 1103 Kaliste Saloom Rd, in the city of Lafayette, state of LA, with the postal code 705085783.
What is Judd Tanner Broussard's specialized field of practice, and what is the corresponding taxonomy classification code?
The Judd Tanner Broussard's area of specialization is Nurse Anesthetist, Certified Registered, and the corresponding taxonomy code that categorizes this field of practice is 367500000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1073612693 to Judd Tanner Broussard?
The Centers for Medicare & Medicaid Services assigned the 1073612693 to Judd Tanner Broussard on 2006-09-21.
When was the information regarding Judd Tanner Broussard, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Judd Tanner Broussard, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2010-07-29.