Provider Demographics
NPI:1679451009
Name:LEBLANC, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LEBLANC
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 GREENWAY CREEK VW APT 321
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3495
Mailing Address - Country:US
Mailing Address - Phone:858-750-9450
Mailing Address - Fax:
Practice Address - Street 1:1355 GARDEN OF THE GODS RD STE 130
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3595
Practice Address - Country:US
Practice Address - Phone:719-476-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0339097164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse