# JENNELLE LEBEAU

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356034094
- **Gender:** F
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171000000X | Military Health Care Provider | — | — | — |
| 207Q00000X | Family Medicine Physician | 202403618 | NC | Yes |
| 208D00000X | General Practice Physician | 2024-03618 | NC | Yes |

## Other

- **Enumeration date:** 05/30/2023
- **Last updated:** 09/13/2026