Provider Demographics
NPI:1306375571
Name:LEBRUN, ADIANIE
Entity Type:Individual
Prefix:MRS
First Name:ADIANIE
Middle Name:
Last Name:LEBRUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1293 N UNIVERSITY DR # 230
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1293 N UNIVERSITY DR # 230
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6696
Practice Address - Country:US
Practice Address - Phone:848-248-2159
Practice Address - Fax:978-709-7577
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5220490164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse