Look up the most recent NPI and PECOS records

Laura Ann Lebourdais

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

887 Congress St, Portland, ME 04102-3100

PECOS Enrollment

This provider is enrolled in PECOS as LAURA LEBOURDAIS.

Based on the most recent information from CMS, provider Laura Ann Lebourdais is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:35 PM.

Profile Details

Provider ID
1104349133
Provider Type
Individual
Full Name
Lebourdais, Laura Ann
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
7/21/2017
Last Updated
3/17/2018

Contact Information

Practice Location

887 Congress St, Portland, ME 04102-3100

(207) 774-6368

(207) 774-9388

Mailing Location

56 Exchange St Apt 33, Portland, ME 04101-5032

(207) 522-5964

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Laura Ann Lebourdais

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Wallace, Chase E

Hazen, Gordon Loughlin

Joldersma, Logan

Mehler, Laura Kolker

Lyon, Devin Judith

Previte, Jeffrey G

King, Abby

Lavoie, Sarah A

Palmer, Ashley

Sayward, Lindsay Eve