Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LACEY L JANDRIN, PA-C
ActiveLACEY L JANDRIN, PA-C is a Physician Assistant healthcare provider located in GREEN BAY, Wisconsin. NPI 1104183516 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · GREEN BAY, WI
Registration Details
- NPI Number
- 1104183516
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 23, 2012 (14.305624031375 yrs)
- Last Updated
- Jan 30, 2023
- Licenses
-
4712 (WI)1135070 (WI)3761-23 (WI)
Practice Information
- Address
-
1970 S RIDGE RDGREEN BAY, WI, 543044125Browse WI providers · Browse ZIP 54304
- Phone
- 9204304888
- Fax
- 9204304889
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in GREEN BAY, WI
| Name | Credential | NPI |
|---|---|---|
| ANGELA LAMACK | PA | 1285634899 |
| MRS. HEATHER RIESSLAND ALLEN | P.A | 1780675603 |
| TRACEY W BEFAY | PA | 1053395913 |
| MR. HOWARD L RETTMANN | PA-C | 1083698633 |
| PENNY S CORNELIUS | PA | 1184609331 |
| ELAINE M SMITH | PA | 1285684662 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.