Provider Demographics
NPI:1447002654
Name:LEBEAU, BLAKELEY CHAUVIN (FNP)
Entity type:Individual
Prefix:MS
First Name:BLAKELEY
Middle Name:CHAUVIN
Last Name:LEBEAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5423 PARLANGE LN
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:LA
Mailing Address - Zip Code:70755-3008
Mailing Address - Country:US
Mailing Address - Phone:225-718-8582
Mailing Address - Fax:
Practice Address - Street 1:4801 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6917
Practice Address - Country:US
Practice Address - Phone:337-470-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234735363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner