Individual
LAUREN WAGNER WILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 DELAFIELD ST, WAUKESHA, WI 53188-3417
(262) 754-4488
Mailing address
13800 W NORTH AVE STE 100, BROOKFIELD, WI 53005-4977
(262) 754-4488
(262) 754-4940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3319
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215341920
—
WI
Enumeration date
06/20/2014
Last updated
03/17/2018
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