Individual
LAURA S OLDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3077 N MAYFAIR RD STE 305, WAUWATOSA, WI 53222-4305
(414) 384-6700
(414) 727-1058
Mailing address
3077 N MAYFAIR RD STE 305, WAUWATOSA, WI 53222-4305
(414) 384-6700
(414) 727-1058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1747023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42879000
—
WI
Enumeration date
09/11/2006
Last updated
03/03/2020
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