Individual
LAUREN ASHLEY PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
127 HOSPITAL DR, WATERTOWN, WI 53098-3300
(920) 261-8500
Mailing address
127 HOSPITAL DR, WATERTOWN, WI 53098-3300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2020
Last updated
04/07/2022
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