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Individual

JUSTIN TIMOTHY LEGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1620 COMMERCE BLVD STE C, OPELOUSAS, LA 70570-2066
(337) 594-0675
(781) 464-2551
Mailing address
1620 COMMERCE BLVD STE C, OPELOUSAS, LA 70570-2066
(337) 594-0675
(781) 464-2551

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP07916
LA
363LF0000X
Family Nurse Practitioner
AP07916
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2381920
LA
Enumeration date
12/30/2014
Last updated
05/07/2024
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