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General NPI Number Information
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NPI Number | 1811681299
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Entity Type | Individual
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Provider Name | LAUREN HEATON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 21239 HIGHWAY 167
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City | DRY PRONG
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State | LA
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Zip | 71423-3503
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Country | US
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Telephone | 318-373-2078
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Fax | 318-373-2079
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Provider Business Mailing Address
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Address Line | 4702 MONROE HWY
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City | BALL
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State | LA
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Zip | 71405-3944
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Country | US
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Telephone | 318-641-6113
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Fax | 318-641-6115
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 230632
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License Number State | LA
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