NPI 1023484920

Latrisha Broussard, PHARMD

Practitioner Pharmacist Monroe, LA

Practice location

Address: 2801 Louisville Ave, Monroe, LA 71201-6655
Phone: (318) 387-6023
Fax: (318) 387-6367
Mailing address: 105 Tulip Wood Dr, Monroe, LA 71203-2477

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 017727 (LA)

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Registry record

NPI: 1023484920
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Aug 2015
Record last updated: 13 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.