Provider Demographics
NPI:1326436759
Name:SCHWALLS, LAURA ASHLEY (NP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ASHLEY
Last Name:SCHWALLS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 31ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31768-6703
Mailing Address - Country:US
Mailing Address - Phone:229-217-0088
Mailing Address - Fax:229-217-0086
Practice Address - Street 1:207 31ST AVE SE
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-6703
Practice Address - Country:US
Practice Address - Phone:229-217-0088
Practice Address - Fax:229-217-0086
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN211599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily