Grundy, Lori Leblanc

Grundy, Lori Leblanc is an individual health care provider with primary practice located at 1355 Sam Houston Jones Pkwy , Lake Charles LA 70611-5470. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Grundy, Lori Leblanc can be contacted via phone (337) 513-0299.

Contact Information

Primary practice address
1355 Sam Houston Jones Pkwy Lake Charles LA 70611-5470
Phone: (337) 513-0299
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00230 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA08214 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA.200509 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA.200509 Louisiana

Profile Details

NPI number 1528339918
LBN Legal business name Grundy, Lori Leblanc
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2012
Last updated Oct 11th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528339918 NPPES
Mississippi MEDICAID 06082548

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