Provider Demographics
NPI:1750678132
Name:LEBLANC, SHIRLEY DON (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:DON
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 BROADWAY STE 5
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-3209
Mailing Address - Country:US
Mailing Address - Phone:806-765-2605
Mailing Address - Fax:806-687-5957
Practice Address - Street 1:1313 BROADWAY STE 5
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401-3209
Practice Address - Country:US
Practice Address - Phone:806-765-2605
Practice Address - Fax:806-687-5957
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP105256363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health