Provider Demographics
NPI:1033477740
Name:JAEGER, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:JAEGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 68TH AVE
Mailing Address - Street 2:APT. 1
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-8614
Mailing Address - Country:US
Mailing Address - Phone:715-292-1744
Mailing Address - Fax:
Practice Address - Street 1:515 S 68TH AVE
Practice Address - Street 2:APT. 1
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-8614
Practice Address - Country:US
Practice Address - Phone:715-292-1744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI177925163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse