Individual
JILL ANNE LEBOURDAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4905 BERL DR, SAGINAW, MI 48604-2801
(989) 996-0566
(989) 583-6915
Mailing address
3785 BAY RD, SAGINAW, MI 48603-2433
(989) 791-2455
(989) 791-1392
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003221
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0992118
HEALTH PLUS
MI
01
—
26401
HEALTH PLAN OF MI
MI
05
—
4472609
—
MI
01
—
5731192
BCBSM
MI
01
—
P00088330
RAILROAD MEDICARE
—
Enumeration date
04/25/2006
Last updated
05/11/2017
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