Provider Demographics
NPI:1093134694
Name:LEBLANC, HOPE (NP)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MALLISON FALLS RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-4101
Mailing Address - Country:US
Mailing Address - Phone:207-893-7080
Mailing Address - Fax:207-892-0173
Practice Address - Street 1:17 MALLISON FALLS RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4101
Practice Address - Country:US
Practice Address - Phone:207-893-7080
Practice Address - Fax:207-892-0173
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81003363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health