Healthcare Provider Details

I. General information

NPI: 1538049820
Provider Name (Legal Business Name): JAMIE A LORRIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 W 20TH AVE
OSHKOSH WI
54902-6650
US

IV. Provider business mailing address

1259 W 20TH AVE
OSHKOSH WI
54902-6650
US

V. Phone/Fax

Practice location:
  • Phone: 920-651-3600
  • Fax:
Mailing address:
  • Phone: 920-651-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number17400-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: