Provider Demographics
NPI:1275613044
Name:LEBLANC, ELIZABETH JAMES (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JAMES
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LAKEVIEW DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7511
Mailing Address - Country:US
Mailing Address - Phone:985-898-1940
Mailing Address - Fax:985-809-0425
Practice Address - Street 1:110 LAKEVIEW DR
Practice Address - Street 2:SUITE 100
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7511
Practice Address - Country:US
Practice Address - Phone:985-898-1940
Practice Address - Fax:985-809-0425
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily