Provider Demographics
NPI:1144415605
Name:SCHEYD, MARY M (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:SCHEYD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:MOUTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:PO BOX 54494
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70154-4494
Mailing Address - Country:US
Mailing Address - Phone:985-871-4140
Mailing Address - Fax:985-871-4150
Practice Address - Street 1:1006 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3661
Practice Address - Country:US
Practice Address - Phone:985-871-4140
Practice Address - Fax:985-871-4150
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN088590 AP04926363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1022110Medicaid
LA1022110Medicaid