Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN094711 | LA |
NPI | 1033108238 |
---|---|
Provider Name | Mrs. Jennifer Henderson Leblanc |
First Address | Baton Rouge, LA 70809-2725 |
Second Address | Baton Rouge, LA 70809-2725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 26/06/2009 |