Healthcare Provider Details

I. General information

NPI: 1548817661
Provider Name (Legal Business Name): LAUREN SEITER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E CAMPUS MALL
MADISON WI
53715-1365
US

IV. Provider business mailing address

333 E CAMPUS MALL
MADISON WI
53715-1365
US

V. Phone/Fax

Practice location:
  • Phone: 608-262-9884
  • Fax:
Mailing address:
  • Phone: 608-262-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10064-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: