Provider Demographics
NPI:1952638983
Name:LEBEOUF, ANNA KATHALENE (PNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHALENE
Last Name:LEBEOUF
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3220 CENTRAL MALL DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8037
Mailing Address - Country:US
Mailing Address - Phone:409-729-7900
Mailing Address - Fax:409-727-5277
Practice Address - Street 1:3220 CENTRAL MALL DR
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8037
Practice Address - Country:US
Practice Address - Phone:409-729-7900
Practice Address - Fax:409-727-5277
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX583273363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics