Healthcare Provider Details

I. General information

NPI: 1851372957
Provider Name (Legal Business Name): JULIE K LASSA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 2ND ST N STE 200
LA CROSSE WI
54601-2001
US

IV. Provider business mailing address

300 2ND ST N STE 220
LA CROSSE WI
54601-2001
US

V. Phone/Fax

Practice location:
  • Phone: 608-860-8713
  • Fax: 715-833-0669
Mailing address:
  • Phone: 608-860-8713
  • Fax: 715-833-0669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2332-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: