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KENDRA BROUSSARD NNP
NPI 1346616604
Nurse Practitioner - Neonatal, Critical Care in Salt Lake City, UT

Active since August 20, 2015
50 N MEDICAL DR, NICU, SALT LAKE CITY, UT 84132(801) 581-2113 Get Directions Write a Review

NPPES record last updated: August 4, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 4, 2022, Jul 22, 2021, Apr 2, 2017 (3 updates tracked since 2017).

About Kendra Broussard Nnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDRA BROUSSARD NNP (NPI 1346616604) is an individual neonatal, critical care provider in Salt Lake City, Utah, licensed in Georgia (RN198466) and active in the NPI registry since August 2015.

NPPES Registry Identity

NPI1346616604
Entity TypeIndividualFemale
Primary Taxonomy363LN0005X
Provider Legal NameKENDRA BROUSSARDCredential: NNP
Location Address50 N MEDICAL DR, NICUSalt Lake City, UT 84132-0001
Mailing AddressPo Box 742616Atlanta, GA 30374-2616
Phone(801) 581-2113
Sole ProprietorNo
Enumeration DateAugust 20, 2015
Last NPPES UpdateAugust 4, 20223 updates tracked since enumeration
NPPES CertifiedNovember 29, 2021
✔ NPI 1346616604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Neonatal, Critical CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0005X
Licenses✔ Licensed in GA · RN198466✔ Licensed in UT · 8834868-4405
Also ListedNurse Practitioner · NeonatalTaxonomy 363LN0000X · License RN198466 (GA)
50 N MEDICAL DR, Salt Lake City, UT 84132
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF UTAH ADULT SERVICES
Otolaryngology
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 587-6336
ADAM PORTER MOTR/L
Occupational Therapist
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-2119
DR. ERICA JANE ALEXANDRA COLVIN MD
Emergency Medicine
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
MEGAN MEIER MD
Internal Medicine (Rheumatology)
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
STACI LEE GUNTER PA-C
Physician Assistant (Surgical)
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6908
MATTHEW D. O'DELL MD
Internal Medicine
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7899
WATARU HORIGUCHI
Student in an Organized Health Care Education/Training Program
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
JEANELLE WEBB
Registered Nurse
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (925) 510-0868

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendra Broussard's NPI number?

The NPI number for Kendra Broussard is 1346616604. It was assigned to this individual provider in the NPPES registry on August 20, 2015.

Where is Kendra Broussard located?

Kendra Broussard practices at 50 N Medical Dr Nicu, Salt Lake City, UT 84132. The listed phone number is (801) 581-2113.

What is Kendra Broussard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, Critical Care, with taxonomy code 363LN0005X.

When was this NPI record last updated?

The NPPES record for Kendra Broussard was last updated on August 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.