Provider Demographics
NPI:1053626291
Name:LEBLANC, ANN M (RPH)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2054
Mailing Address - Country:US
Mailing Address - Phone:985-641-5557
Mailing Address - Fax:985-646-0646
Practice Address - Street 1:1260 FRONT ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2054
Practice Address - Country:US
Practice Address - Phone:985-641-5557
Practice Address - Fax:985-646-0646
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist