Provider Demographics
NPI:1154349694
Name:SCHEFFY, LAUREN P (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:P
Last Name:SCHEFFY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8525 LINE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106
Mailing Address - Country:US
Mailing Address - Phone:318-300-4926
Mailing Address - Fax:318-383-3951
Practice Address - Street 1:8525 LINE AVE STE A
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-4531
Practice Address - Country:US
Practice Address - Phone:318-300-4926
Practice Address - Fax:318-383-3951
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA30271363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1628581Medicaid
LA56742P980Medicare PIN
LAQ37603Medicare UPIN
LA1628581Medicaid