Basic Information
Provider Information
NPI: 1457822363
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEIGHNER
FirstName: LAUREN
MiddleName: HEBB
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 75 GALES WAY
Address2:  
City: NEWNAN
State: GA
PostalCode: 302637202
CountryCode: US
TelephoneNumber: 6788637596
FaxNumber:  
Practice Location
Address1: 189 HOSPITAL DR
Address2:  
City: SPRUCE PINE
State: NC
PostalCode: 287773035
CountryCode: US
TelephoneNumber: 8287663555
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/17/2018
LastUpdateDate: 10/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X0010-08454NCY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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