Provider Demographics
NPI:1780231910
Name:NEWELL, LAUREN E (APNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:NEWELL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:E
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-1450
Mailing Address - Fax:414-955-0197
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-1450
Practice Address - Fax:414-955-0197
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI201057163W00000X
WI9550-33363L00000X
WI9550363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1780231910Medicaid