Healthcare Provider Details

I. General information

NPI: 1972416980
Provider Name (Legal Business Name): LAUREN DOVE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4935 S 76TH ST
GREENFIELD WI
53220-9900
US

IV. Provider business mailing address

4935 S 76TH ST
GREENFIELD WI
53220-9900
US

V. Phone/Fax

Practice location:
  • Phone: 414-777-3100
  • Fax: 160-988-1077
Mailing address:
  • Phone: 414-777-3100
  • Fax: 160-988-1077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19163-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: