Provider Demographics
NPI:1538961172
Name:LEBOEUF, CHRISTIAN (BSN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:LEBOEUF
Suffix:
Gender:
Credentials:BSN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 APOLLO RD APT 5309
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-5440
Mailing Address - Country:US
Mailing Address - Phone:985-856-8237
Mailing Address - Fax:
Practice Address - Street 1:1921 DULLES DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-2716
Practice Address - Country:US
Practice Address - Phone:337-579-5777
Practice Address - Fax:337-735-7858
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA217363163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse