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

Shana Marie Broussard

Individual provider Family Nurse Practitioner · NPI 1134740798

Shana Marie Broussard is a Nurse Practitioner in Vancleave, Mississippi. Qualified in 2019, 7 years ago. Practices with Ocean Springs Urgent Care, a 19-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
7
Licensed in
MS
In the registry since
2020

Practice location Address checks out

10404 Tucker Rd # Llc
Vancleave, MS 39565-7922
Phone: (228) 354-9505
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 903748 (MS)

Record details

NPI number1134740798
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 5, 2020
Last updated in NPPESJune 24, 2020
Certification dateJune 24, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ocean Springs Urgent Care — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Vancleave