Provider Demographics
NPI:1720557366
Name:LEBLANC, JESSICA MI
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MI
Last Name:LEBLANC
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 1:435 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:LA
Mailing Address - Zip Code:70079-2119
Mailing Address - Country:US
Mailing Address - Phone:504-669-3143
Mailing Address - Fax:
Practice Address - Street 1:435 OAK ST
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:LA
Practice Address - Zip Code:70079-2119
Practice Address - Country:US
Practice Address - Phone:504-669-3143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula