Individual
LAURA P VAN ROO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1225 BONGARD DR, WAUNAKEE, WI 53597-2657
(608) 239-7321
Mailing address
1225 BONGARD DR, WAUNAKEE, WI 53597-2657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1355-023
WI
363AM0700X
Medical Physician Assistant
Primary
1355-023
WI
363AS0400X
Surgical Physician Assistant
1355-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41961500
—
WI
01
—
60073
DEAN HEALTH INSURANCE
WI
Enumeration date
05/06/2006
Last updated
04/28/2026
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