Healthcare Provider Details

I. General information

NPI: 1841343746
Provider Name (Legal Business Name): MARY L. LEJEUNE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 WEST SECOND STREET P.O. DRAWER 1403
CROWLEY LA
70527-1403
US

IV. Provider business mailing address

1822 WEST SECOND STREET P.O. DRAWER 1403
CROWLEY LA
70527-1403
US

V. Phone/Fax

Practice location:
  • Phone: 337-788-7511
  • Fax: 337-788-7588
Mailing address:
  • Phone: 337-788-7511
  • Fax: 337-788-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN094829
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: