MEDICARE: KAYLEY LEBLANC FNP-C

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
1	363LF0000X	Family Nurse Practitioner	217251	OK

General Provider Information

NPI Number	:	1255204525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEY LEBLANC FNP-C

Provider Business Mailing Address
First Line	:	2308 SW 56TH ST
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-5038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5404 SW LEE BLVD
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-9521
Country	:	US
Telephone Number	:	580-355-5242
Fax Number	:	580-355-5245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	12/10/2025

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