Individual
JENNIFER S LEBLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1210 MEDICAL ARTS BLVD, SUITE 201, ANDERSON, IN 46011-3461
(765) 298-5280
(765) 298-5279
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004028A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201082550
—
IN
01
—
P01157053
RR MEDICARE PTAN
IN
Enumeration date
07/31/2012
Last updated
11/27/2023
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