Kimberly Broussard
NPI 1477908275 · Preferred Provider Organization · Las Vegas, NV
Kimberly Broussard is a Preferred Provider Organization organization in Las Vegas, NV (NPI 1477908275).
Provider details
- NPI number
- 1477908275
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Kimberly Broussard, Owner / Operator(702) 807-1718
Specialties & taxonomies
Managed Care Organizations
- Behavior Analyst103K00000X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Phenomenal Angels
Registry dates
- Enumerated
- 2016-04-28
- Last updated
- 2016-04-29
Frequently asked questions
- What is Kimberly Broussard's NPI number?
- Kimberly Broussard's National Provider Identifier (NPI) is 1477908275, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kimberly Broussard?
- Kimberly Broussard is classified in the NPPES registry as Preferred Provider Organization (Managed Care Organizations).
- Where is Kimberly Broussard located?
- Kimberly Broussard's practice location on file with NPPES is 3380 E Russell Rd, Las Vegas, NV 89120-3402.
- What is Kimberly Broussard's phone number?
- The practice phone number listed in the NPPES registry for Kimberly Broussard is (702) 476-0448.
- Who is the authorized official for Kimberly Broussard?
- The authorized official listed on Kimberly Broussard's NPPES record is Kimberly Broussard, Owner / Operator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kimberly Broussard's NPI active?
- Yes — Kimberly Broussard's NPI (1477908275) is active in the NPPES registry as of the last update on 2016-04-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.