Individual
MS. LORI S. G. VERSEMAN
Active
Individual
MS. LORI S. G. VERSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085000314
IL
363AM0700X
Medical Physician Assistant
Primary
7210
WI
Other
Enumeration date
08/11/2006
Last updated
05/23/2023
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