Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kendra Broussard, NNP

Individual provider Neonatal Nurse Practitioner · NPI 1346616604

Kendra Broussard, NNP is a Neonatal Nurse Practitioner in Salt Lake City, Utah. Licensed in Georgia and Utah. Registered with an NPI since 2015.

Licensed in
GA, UT
In the registry since
2015
Specialties on file
3

Practice location Address checks out

50 N Medical Dr NICU
Salt Lake City, UT 84132-0001
Phone: (801) 581-2113
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Neonatal Nurse Practitioner (primary) Taxonomy 363LN0005X · Licence RN198466 (GA)
Neonatal Nurse Practitioner Taxonomy 363LN0000X · Licence RN198466 (GA)
Critical Care Neonatal Nurse Practitioner Taxonomy 363LN0005X · Licence 8834868-4405 (UT)

Record details

NPI number1346616604
Entity typeIndividual (Type 1)
GenderFemale
Credentials NNP
Sole proprietorNo
NPI enumeratedAugust 20, 2015
Last updated in NPPESAugust 4, 2022
Certification dateNovember 29, 2021
Mailing addressPo Box 742616, Atlanta, GA 30374-2616

Other providers in Salt Lake City