Provider Demographics
NPI:1518228493
Name:WEGEHAUPT, LAURA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:WEGEHAUPT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 A ST
Mailing Address - Street 2:LINCOLN ORTHOPAEDIC CENTER
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4120
Mailing Address - Country:US
Mailing Address - Phone:402-436-2000
Mailing Address - Fax:402-436-2929
Practice Address - Street 1:6900 A ST
Practice Address - Street 2:LINCOLN ORTHOPAEDIC CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4120
Practice Address - Country:US
Practice Address - Phone:402-436-2000
Practice Address - Fax:402-436-2929
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE91177983213Medicaid