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Individual

LAURIE J TIERNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 S PARK ST STE A, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2967
Mailing address
700 S PARK ST STE A, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2967

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3664-023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881064426
WI
Enumeration date
09/25/2015
Last updated
12/14/2020
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