Mayeux, Romona Broussard

Mayeux, Romona Broussard is an individual health care provider with primary practice located at 248 E Capitol St Room 105, Jackson MS 39201-2503. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mayeux, Romona Broussard can be contacted via phone (601) 714-2563.

Contact Information

Primary practice address
248 E Capitol St Room 105 Jackson MS 39201-2503
Phone: (601) 714-2563
Fax: (601) 510-4653
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN041380 AP01824 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R881289 Mississippi

Profile Details

NPI number 1437151636
LBN Legal business name Mayeux, Romona Broussard
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Jan 13th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437151636 NPPES
Louisiana Other AP01824 APN LICENSE NUMBER
Louisiana MEDICAID 1655244 APN LICENSE NUMBER
Louisiana Other R881289 APN LICENSE NUMBER
Louisiana Other RN041380 APN LICENSE NUMBER

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