Individual
LOUISE A LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LNP
Contact information
Practice address
5895 TRINITY PKWY, SUITE 100, CENTREVILLE, VA 20120-1995
(703) 802-2004
Mailing address
5895 TRINITY PKWY, SUITE 100, CENTREVILLE, VA 20120-1995
(703) 802-2004
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0017136834
VA
363LA2200X
Adult Health Nurse Practitioner
0024164061
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017136834
AUTH TO PRESCRIBE LICENSE
VA
Enumeration date
12/04/2007
Last updated
10/06/2011
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