Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Liece Laurens, PA-C

Individual provider Medical Physician Assistant · NPI 1619519915

Mrs. Liece Laurens, PA-C is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2019, 7 years ago. Practices with Qhg of Fort Wayne Company LLC, a 14-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
7
Licensed in
IN
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7333 W Jefferson Blvd
Fort Wayne, IN 46804-6280
Phone: (260) 458-3830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10002825A (IN)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1619519915
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 8, 2019
Last updated in NPPESJanuary 6, 2020
Certification dateJanuary 6, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Qhg Of Fort Wayne Company Llc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fort Wayne