Individual
TRAVIS CHRISTOPHER LEGLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
104 DANIEL LN, NEW IBERIA, LA 70563-1285
(225) 776-2958
Mailing address
104 DANIEL LN, NEW IBERIA, LA 70563-1285
(225) 776-2958
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
206762
LA
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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