Kristin M Lavenhagen, PA-C

NPI #1154635860 in Oak Creek, Wisconsin

Provider Information

NPI Number: 1154635860
Entity Type: Individual
Name: Kristin M Lavenhagen, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Aug 5, 2010
Last Updated: Sep 28, 2012

Practice Location

Address: 331 E PUETZ RD
Address 2: LAKESHORE MEDICAL CLINIC
City: Oak Creek
State: Wisconsin
ZIP Code: 53154-3253
Phone: (414) 570-3590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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