MRS. LAURA M. VAN RYN (NPI# 1871880591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871880591 |
| Entity Type | Individual |
| Full Name | MRS. LAURA M. VAN RYN |
| Other Name | LAURA M. OTTO |
| Credential | PA-C |
| Practice Address |
411 Westwood Dr Wausau WI 54401-4152 |
| Practice Telephone | 7158472558 |
| Practice Fax Number | 7158472752 |
| Mailing Telephone | 7158472558 |
| Mailing Fax Number | 7158472752 |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2013-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2772-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
411 WESTWOOD DR |
| City | WAUSAU |
| State | WI |
| Zip Code | 54401-4152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104821651 | Michael J Hein | Nurse Anesthetist, Certified Registered | 411 Westwood Dr, Wausau, WI 54401-4152 | 2005-06-20 |
| 1932548112 | Breanna T Wentland | Physician Assistant | 411 Westwood Dr, Wausau, WI 54401-4152 | 2013-06-20 |
| 1104164417 | Marissa J Hernandez | Nurse Anesthetist, Certified Registered | 411 Westwood Dr, Wausau, WI 54401 | 2013-01-21 |
| 1154689685 | Justin Gabriel Hartke | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401 | 2012-05-03 |
| 1932465523 | Adam Christopher Godsey | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2012-04-08 |
| 1063788503 | Melinda Rae Wayde | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2012-03-29 |
| 1619108743 | Laura B Schlund | Nurse Practitioner | 411 Westwood Dr, Wausau, WI 54401-4152 | 2009-08-06 |
| 1962663559 | Gastrointestinal Associates Endoscopy Center, LLC | Clinic/Center | 411 Westwood Dr, Wausau, WI 54401 | 2008-06-17 |
| 1154504538 | Veronika Gagovic | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2007-12-09 |
| 1760546949 | Gastrointestinal Associates S.c. | Internal Medicine | 411 Westwood Dr, Wausau, WI 54401-4152 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1336701895 | Amy Kluetz | Counselor | 3000 Westhill Drive, Suite 100, Wausau, WI 54401 | 2019-07-05 |
| 1437640877 | Joseph T Fitz | Student in an Organized Health Care Education/Training Program | Aspirus Wausau Family Medicine, 425 Wind Ridge Drive, Wausau, WI 54401 | 2018-05-22 |
| 1699293241 | Amanda Nedd | Dietitian, Registered | 425 Pine Ridge Boulevard Suite 220 C, Wausau, WI 54401 | 2017-09-05 |
| 1396287447 | Dee Cha | Nurse Anesthetist, Certified Registered | 4851 Rachel Ln Apt 5, Wausau, WI 54401 | 2016-11-07 |
| 1013389618 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 2727 Plaza Dr., Wausau, WI 54401 | 2015-10-22 |
| 1881091163 | Judy Lao | Dental Hygienist | 413 North 17th Avenue, Wausau, WI 54401 | 2014-12-02 |
| 1295012011 | Allison Waraksa | Pharmacist | 504 S. 17th Ave, Wausau, WI 54401 | 2011-11-08 |
| 1881974053 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 S 17th Ave, Wausau, WI 54401 | 2011-08-19 |
| Find all providers in zip 54401 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1942852504 | Patrick Henry Drechsler | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2019-07-14 |
| 1306407010 | Abbey Crossman | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2019-06-24 |
| 1477905909 | Aaron Follensbee | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2016-07-08 |
| 1952742397 | Jessica Gaffaney | Physician Assistant | 333 Pine Ridge Blvd, Emergency Dept, Wausau, WI 54401-4120 | 2013-07-15 |
| 1649574898 | Daniel Thomas Line | Physician Assistant | 333 Pine Ridge Blvd, Wausau, WI 54401-4120 | 2011-01-03 |
| 1699087411 | Jacklyn A Knoll | Physician Assistant | 500 Wind Ridge Dr, Wausau, WI 54401-4173 | 2010-07-09 |
| 1124352604 | Mollie J Berg | Physician Assistant | 2720 Plaza Dr, Suite 1100, Wausau, WI 54401-4158 | 2009-09-30 |
| 1942225339 | Sarah E Jaeger | Physician Assistant | 1810 N 2nd St, Wausau, WI 54401 | 2006-07-13 |
| 1851316871 | Brenda K Balthazor | Physician Assistant | 512 S 28th Ave, Wausau, WI 54401-4147 | 2006-07-12 |
| Find all providers in WAUSAU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.