Provider Demographics
NPI:1386788339
Name:LE BLOND, ANITA CARAIG (ANP, GNP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:CARAIG
Last Name:LE BLOND
Suffix:
Gender:F
Credentials:ANP, GNP
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:C
Other - Last Name:LE BLOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP, GNP
Mailing Address - Street 1:492 TABRIZ DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-2860
Mailing Address - Country:US
Mailing Address - Phone:319-321-2977
Mailing Address - Fax:
Practice Address - Street 1:2023 LAURENCE CT NE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-9150
Practice Address - Country:US
Practice Address - Phone:319-358-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH-097905363LA2200X
IAJ-097905363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology