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1023564812
GINA LEISHA BROUSSARD
MERCED, CA
NPI
1023564812
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 565760)
Enumeration Date
2016-08-31
Last Update Date
2024-08-09
Business Address
Ms. GINA LEISHA BROUSSARD FNP
3349 G ST STE F
MERCED, CA 95340-0978
Phone number: 209-349-8459
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Mailing Address
Ms. GINA LEISHA BROUSSARD FNP
1154 GRANITE CT
MERCED, CA 95340-0675
Phone number: 209-628-9204
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