Individual
JAMIE ROGALLA LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3200 WESTHILL DR STE 201, WAUSAU, WI 54401-4707
(715) 847-2382
(715) 847-2381
Mailing address
3200 WESTHILL DR STE 201, WAUSAU, WI 54401-4707
(715) 847-2382
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
011003949
VA
363A00000X
Physician Assistant
0110003949
VA
363A00000X
Physician Assistant
Primary
4319-23
WI
Other
Enumeration date
08/22/2012
Last updated
11/11/2025
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