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NPI Code Detail

MEDICARE: MRS. LAUREN PAIGE WAHLMEIER PA-C

MEDICARE: MRS. LAUREN PAIGE WAHLMEIER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPT2018-004AR

General Provider Information

NPI Number : 1952817587
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN PAIGE WAHLMEIER PA-C
Provider Business Mailing Address
First Line : 508 N 14TH ST
Second Line :
City : VAN BUREN
State : AR
Zip : 72956-4548
Country : US
Telephone Number : 479-651-8749
Fax Number :
Provider Business Practice Location Address
First Line : 3501 WE KNIGHT DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6254
Country : US
Telephone Number : 479-709-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2017
Last Update Date : 12/04/2018

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