MEDICARE: MRS. LAURIE SMITH STIGER APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	659149	TX
2	363LF0000X	Family Nurse Practitioner	AP125095	TX
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	A004407	AR
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP125095	TX
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP220808	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP125095	OTHER	TX	APRN, FNP-C, PMHNP-BC
2	A004407	OTHER	AR	PSYCHIATRY APRN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	70904	OTHER	NM	APRN, PMHNP-BC

General Provider Information

NPI Number	:	1942630959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURIE SMITH STIGER APRN

Provider Business Mailing Address
First Line	:	2920 KNIGHT ST STE 102
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2412
Country	:	US
Telephone Number	:	318-771-2008
Fax Number	:	318-374-6467

Provider Business Practice Location Address
First Line	:	2920 KNIGHT ST STE 102
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2412
Country	:	US
Telephone Number	:	318-771-2008
Fax Number	:	318-374-6467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2013
Last Update Date	:	01/14/2023

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