Individual
LAUREN RENEE STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4602 EASTPARK BLVD, MADISON, WI 53718-2002
(608) 263-1530
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4897-23
WI
363AM0700X
Medical Physician Assistant
Primary
4897
WI
Other
Enumeration date
01/16/2020
Last updated
10/21/2022
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