Healthcare Provider Details

I. General information

NPI: 1275066979
Provider Name (Legal Business Name): LAUREN ELIZABETH LEBLANC PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 OCHSNER BLVD
COVINGTON LA
70433-8172
US

IV. Provider business mailing address

5750 JOHNSTON ST # 200
LAFAYETTE LA
70503-5334
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-6900
  • Fax:
Mailing address:
  • Phone: 985-980-0111
  • Fax: 985-202-8193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9110305
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number350849
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: