Individual ProviderMonique BroussardPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1514 Jefferson Hwy, Jefferson, LA 70121-2429(504) 842-3000(337) 504-9439PECOS EnrollmentBased on the most recent information from CMS, provider Monique Broussard is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1356145890Provider TypeIndividualFull NameBroussard, MoniqueCredentialPASole ProprietorYesEnumeration Date4/3/2025Last Updated4/3/2025Contact InformationPractice LocationPractice Address1514 Jefferson Hwy, Jefferson, LA 70121-2429Phone(504) 842-3000FaxUnlisted FaxMailing LocationMailing Address214 Portsmouth Dr, Broussard, LA 70518-3539Phone(337) 504-9439FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AM0700XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer