Healthcare Provider Details

I. General information

NPI: 1508790015
Provider Name (Legal Business Name): MICHELLE LEJEUNE LANGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 46
LACASSINE LA
70650-0046
US

IV. Provider business mailing address

PO BOX 46
LACASSINE LA
70650-0046
US

V. Phone/Fax

Practice location:
  • Phone: 337-494-3035
  • Fax:
Mailing address:
  • Phone: 337-494-3035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberRN152091
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: