Provider Demographics
NPI:1780035527
Name:MARSICEK, LAUREN (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MARSICEK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:ZIEBOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4100 STATE HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54482-8410
Mailing Address - Country:US
Mailing Address - Phone:715-343-7700
Mailing Address - Fax:715-343-7735
Practice Address - Street 1:4100 STATE HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54482-8410
Practice Address - Country:US
Practice Address - Phone:715-343-7700
Practice Address - Fax:715-343-7735
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3763-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant