Basic Information
| Provider Information | |||||||||
| NPI: | 1508250531 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHARDS | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6901 W EDGERTON AVE | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532204420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143255244 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6901 W EDGERTON AVE | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143255244 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2015 | ||||||||
| LastUpdateDate: | 05/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 66622 | WI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.