Provider Demographics
NPI:1952849648
Name:CHOI, LAUREN ELISE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISE
Last Name:CHOI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 TERESA DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-5576
Mailing Address - Country:US
Mailing Address - Phone:516-225-8723
Mailing Address - Fax:
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-7342
Practice Address - Fax:414-805-7348
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY633388-1163W00000X
WI231993163W00000X
NYF340921363LF0000X
WI7390-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse