Individual
LISA LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN2313021
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2313021
MA
Other
Enumeration date
07/10/2019
Last updated
01/04/2023
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