Basic Information
Provider Information
NPI: 1841739810
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAUCIER
FirstName: ASHLYN
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 960482
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731960482
CountryCode: US
TelephoneNumber: 8556868430
FaxNumber: 9042658181
Practice Location
Address1: 1701 OAK PARK BLVD
Address2:  
City: LAKE CHARLES
State: LA
PostalCode: 706018911
CountryCode: US
TelephoneNumber: 3374943000
FaxNumber: 9042658181
Other Information
ProviderEnumerationDate: 02/23/2017
LastUpdateDate: 02/23/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAP09180LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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