Basic Information
Provider Information
NPI: 1811564545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMSTRONG
FirstName: LAUREN
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: CAA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7974 UW HEALTH CT
Address2:  
City: MIDDLETON
State: WI
PostalCode: 535625531
CountryCode: US
TelephoneNumber: 6088295485
FaxNumber:  
Practice Location
Address1: 600 HIGHLAND AVE
Address2:  
City: MADISON
State: WI
PostalCode: 537920001
CountryCode: US
TelephoneNumber: 6082638100
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/10/2021
LastUpdateDate: 06/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X187-17WIY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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