LAURA B PETHAN (NPI# 1194122861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194122861 |
| Entity Type | Individual |
| Full Name | LAURA B PETHAN |
| Other Name | LAURA B SCHARENBROCH |
| Credential | APNP |
| Practice Address |
10 Tower Dr Sun Prairie WI 53590-1239 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 6088253008 |
| Practice Fax Number | 6088253786 |
| Mailing Telephone | 9204457222 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2020-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
7462-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 555 Redbird Cir, De Pere, WI 541157977 | 9203386820 | 9203386829 |
| Street Address |
10 TOWER DR |
| City | SUN PRAIRIE |
| State | WI |
| Zip Code | 53590-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013907310 | Melissa Mcgowan Terrill | Optometrist | 10 Tower Dr, Dean Medical Center, Sun Prairie, WI 53590-1239 | 2005-10-27 |
| 1760989982 | Kimberly K Ward | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2018-04-13 |
| 1205331303 | Laura A. Jacobson | Occupational Therapist | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2018-03-29 |
| 1194242917 | Ashley M Braithwaite | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2017-08-23 |
| 1609315159 | Kailene L Devries | Physician Assistant | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2017-02-16 |
| 1992250112 | Amanda E Conway | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2016-08-17 |
| 1134673783 | Stephanie M Johnson | Nurse Practitioner | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2016-08-12 |
| 1912361452 | Lindsey W Engel | Family Medicine | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2016-04-11 |
| 1154796357 | Eva Balfanz | Counselor | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2015-12-14 |
| 1568839181 | Jolene E Appiah | Occupational Therapist | 10 Tower Dr, Sun Prairie, WI 53590-1239 | 2015-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280529 | Kasi Lucas Schroeder | Chiropractor | 110 N Grand Ave, Suite 4, Sun Prairie, WI 53590 | 2019-02-11 |
| 1770053712 | Jamie Engstrom | Psychologist | 3061 Pleasant St, 216, Sun Prairie, WI 53590 | 2018-12-03 |
| 1154837433 | Wisconsin Dental Health, LLC | Dentist | 390 S. Grand Ave, Suite#110, Sun Prairie, WI 53590 | 2017-12-21 |
| 1669981676 | Elizabeth M Gregg | Counselor | 1170 N Bird St, Sun Prairie, WI 53590 | 2017-09-21 |
| 1609298595 | Prairie Lakes Dental | Dentist | 2804 Prairie Lakes Drive, Sun Prairie, WI 53590 | 2014-01-10 |
| 1407297559 | Quality Medical Rides LLC | Non-emergency Medical Transport (VAN) | 2907 Vang Rd, Sun Prairie, WI 53590 | 2013-07-17 |
| 1376892851 | Costco Wholesale Corporation | Pharmacy | 2850 Hoepker Rd, Sun Prairie, WI 53590 | 2012-08-30 |
| 1043454234 | Dean Lewis Drake | Registered Nurse | 7281 County Rd V. V., Sun Prairie, WI 53590 | 2009-05-01 |
| 1679728992 | Dianne Mary Mayr | Registered Nurse | 3181 Nature Dr, Conservancy States Ln, Sun Prairie, WI 53590 | 2008-12-01 |
| 1043462021 | Crown Point Village, LLC | Assisted Living Facility | 881 Liberty Boulevard, Sun Prairie, WI 53590 | 2008-10-21 |
| Find all providers in zip 53590 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159964 | Caitlin West | Nurse Practitioner | 10823 N Ravine Ct, Mequon, WI 53092-5876 | 2020-06-18 |
| 1639704166 | Angelica Shanahan | Nurse Practitioner | 8733 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2020-03-04 |
| 1609408210 | Jenna Rae Eisold | Nurse Practitioner | 65 W Wood Ridge Dr, River Falls, WI 54022-8291 | 2020-02-11 |
| 1639685274 | Laura Palmer | Nurse Practitioner | 4855 S Moorland Rd # Rod, New Berlin, WI 53151-7494 | 2017-12-19 |
| 1306356589 | Alexandra Wilson | Nurse Practitioner | 3033 W Layton Ave # 102, Greenfield, WI 53221-2628 | 2017-10-02 |
| 1689192775 | Brigid Mary Costello | Nurse Practitioner | 9000 W Wisconsin Ave Ste 620, Milwaukee, WI 53226-4874 | 2017-09-08 |
| 1851643696 | Jamie Harder | Nurse Practitioner | 2574 Sun Valley Dr Ste 207, Delafield, WI 53018-2334 | 2012-10-03 |
| 1760731988 | Nancy J Thompson-quandt | Nurse Practitioner | 7831 Warren Ave, Wauwatosa, WI 53213-2115 | 2012-09-04 |
| 1932471018 | Marie Helen Dietrich | Nurse Practitioner | 201 S Gammon Rd, Madison, WI 53717-1404 | 2012-02-03 |
| 1598993925 | Rebecca R. Rusch | Nurse Practitioner | 13950 W. W. Capitol Drive, Suite 200, Brookfield, WI 53005-2441 | 2009-06-24 |
| Find all providers with the same taxonomy | ||||
| City | SUN PRAIRIE |
| Zip Code | 53590 |
Please comment or provide details below to improve the information on LAURA B PETHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.