Healthcare Provider Details

I. General information

NPI: 1154984128
Provider Name (Legal Business Name): LAURA JEAN SCHOERNING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 LINCOLN STREET FAMILY MEDICINE
WORCESTER MA
01605
US

IV. Provider business mailing address

279 LINCOLN ST
WORCESTER MA
01605-2120
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-8830
  • Fax: 508-334-8810
Mailing address:
  • Phone: 508-334-8830
  • Fax: 508-334-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number294941
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: