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

Mary Jo Broussard

Individual provider Nurse Practitioner · NPI 1285844571

Mary Jo Broussard is a Nurse Practitioner in New Orleans, Louisiana. Qualified in 1997, 29 years ago. Practices with University Medical Center Management Corporation, a 94-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
29
Licensed in
LA
In the registry since
2007
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Practice location Address checks out

1541 Tulane Ave
New Orleans, LA 70112-2821
Phone: (504) 903-1301
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 046359-3340 (LA)

Record details

NPI number1285844571
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 23, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice University Medical Center Management Corporation — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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