Individual
NANCY LUXA-LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
701 N CLAYTON ST, MEDICAL OFFICE BLDG 401, WILMINGTON, DE 19805-3165
(302) 421-4800
(302) 421-4189
Mailing address
701 N CLAYTON ST, MEDICAL OFFICE BLDG 401, WILMINGTON, DE 19805-3165
(302) 421-4800
(302) 421-4189
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C5-0000596
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001001202
—
DE
01
—
2120316000
KEYSTONE
—
01
—
2935112
AETNA
—
01
—
Q41476-51006THOR
BLUE SHIELD DE
—
Enumeration date
03/08/2006
Last updated
04/15/2008
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