Provider Demographics
NPI:1497585541
Name:SALIT, LAUREN ELIZABETH TIEHEN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH TIEHEN
Last Name:SALIT
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 1:839 N MARSHALL ST APT 76
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13133 N PORT WASHINGTON RD STE G16
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-2423
Practice Address - Country:US
Practice Address - Phone:262-243-2500
Practice Address - Fax:262-243-5395
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2025-01-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant