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NPI Code Detail

MEDICARE: KRISTEN LEBLEU LOSAVIO MD

MEDICARE:   KRISTEN LEBLEU LOSAVIO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology PhysicianMD.205348LA

General Provider Information

NPI Number : 1225203904
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN LEBLEU LOSAVIO MD
Provider Business Mailing Address
First Line : 5326 ODONOVAN DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4691
Country : US
Telephone Number : 225-769-7546
Fax Number : 225-769-0471
Provider Business Practice Location Address
First Line : 5326 ODONOVAN DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4691
Country : US
Telephone Number : 225-769-7546
Fax Number : 225-769-0471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2008
Last Update Date : 03/17/2017

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Directions to “ KRISTEN LEBLEU LOSAVIO MD” Practice Location

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