Provider Demographics
NPI:1588000590
Name:LEDET, BRENDA J (APRN, ANP-C)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:J
Last Name:LEDET
Suffix:
Gender:F
Credentials:APRN, ANP-C
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:JENKINS
Other - Last Name:CLELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 CHEROKEE ROSE LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7201
Mailing Address - Country:US
Mailing Address - Phone:985-893-0911
Mailing Address - Fax:985-875-7565
Practice Address - Street 1:170 GREENBRIAR BLVD
Practice Address - Street 2:STE B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7233
Practice Address - Country:US
Practice Address - Phone:985-893-0998
Practice Address - Fax:985-875-7565
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07232363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health