Individual
LAURIE L LEBEGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2164
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
CERT # 037274
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000757541
ANTHEM PROVIDER NUMBER
IN
Enumeration date
03/26/2012
Last updated
05/01/2012
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