Individual
LAUREN MALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
30401 MOUNTAIN LN, WATERFORD, WI 53185-3442
(317) 366-2193
Mailing address
30401 MOUNTAIN LN, WATERFORD, WI 53185-3442
(317) 366-2193
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
233802
WI
163W00000X
Registered Nurse
28211978A
IN
Other
Enumeration date
03/03/2017
Last updated
03/03/2017
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