Provider Demographics
NPI:1811681299
Name:HEATON, LAUREN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:HEATON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:KEOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4702 MONROE HWY
Mailing Address - Street 2:
Mailing Address - City:BALL
Mailing Address - State:LA
Mailing Address - Zip Code:71405-3944
Mailing Address - Country:US
Mailing Address - Phone:318-641-6113
Mailing Address - Fax:318-641-6115
Practice Address - Street 1:21239 HIGHWAY 167
Practice Address - Street 2:
Practice Address - City:DRY PRONG
Practice Address - State:LA
Practice Address - Zip Code:71423-3503
Practice Address - Country:US
Practice Address - Phone:318-373-2078
Practice Address - Fax:318-373-2079
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA230632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily