Healthcare Provider Details

I. General information

NPI: 1427008796
Provider Name (Legal Business Name): STEPHANIE ELAINE LELEUX NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 MONTROSE AVE
LAFAYETTE LA
70503-3852
US

IV. Provider business mailing address

7000 LELEUX RD
NEW IBERIA LA
70560-8102
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-9316
  • Fax:
Mailing address:
  • Phone: 337-521-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1420
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: