Healthcare Provider Details

I. General information

NPI: 1669419164
Provider Name (Legal Business Name): DIANE LAUVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 JUNCTION RD
MADISON WI
53717-2656
US

IV. Provider business mailing address

8007 EXCELSIOR DR
MADISON WI
53717-1962
US

V. Phone/Fax

Practice location:
  • Phone: 608-265-7700
  • Fax:
Mailing address:
  • Phone: 608-829-5247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number202278
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: