| Doctor Name: | MARY RICAUD LEBLANC |
| NPI Number: | 1073932687 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | AP07360 |
| Business Practice Address: | 814 S. Broadway Church Point, LA - 70525 |
| Business Phone Number: | 3376843178 |
| Business Fax Number: | 3376846762 |
| Mailing Address: | P. O. Box 561, CHURCH POINT |
| State: | LA |
| Postal Code: | 70525 |
| Phone Number: | 3377048998 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2014 |
| NPI Last Update Date: | 04/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP07360 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |