Individual
PAIGE ALYSE LAUTTENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3293
SC
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3283PA
—
SC
01
—
SCF8596072
MEDICARE
SC
Enumeration date
06/03/2019
Last updated
01/22/2026
Update your record
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