Healthcare Provider Details

I. General information

NPI: 1174441679
Provider Name (Legal Business Name): LA'SHONDA OILEASE LANCELIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 HEYMANN BLVD
LAFAYETTE LA
70503-2627
US

IV. Provider business mailing address

458 HEYMANN BLVD
LAFAYETTE LA
70503-2627
US

V. Phone/Fax

Practice location:
  • Phone: 337-366-8505
  • Fax:
Mailing address:
  • Phone: 337-366-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number203263
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: