Jo Dee Goodeaux Broussard, PA Valid NPI

Individual provider · Physician Assistant · Lafayette, LA

NPI

1578890190

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

PA200320 (LA)

Sex

Female

Sole proprietor

No

Enumerated

2009-11-04

Last updated

2017-10-06