# MRS. LORI LEBLANC GRUNDY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1528339918
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA.200509 | LA | Yes |
| 363A00000X | Physician Assistant | PA00230 | MS | — |
| 363AM0700X | Medical Physician Assistant | PA.200509 | LA | — |
| 363AM0700X | Medical Physician Assistant | PA08214 | TX | — |

## Other

- **Enumeration date:** 01/18/2012
- **Last updated:** 10/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06082548 | — | MS |