Individual provider · Type 1 NPI

Lacey L. Jandrin, PA-C

Physician Assistant · Green Bay, WI

NPI number 1104183516 Active

Practice location

1970 S Ridge Rd
Green Bay, WI 54304-4125

Call (920) 430-4888 Map

Fax (920) 430-4889

Mailing address

PO Box 22487
Green Bay, WI 54305-2487

Other practice locations

1160 Kepler Dr, Green Bay, WI 54311-8321 · (920) 288-5555
2820 Roosevelt Rd, Marinette, WI 54143-3834 · (715) 735-5225
820 Arbutus Ave, Oconto, WI 54153-2004 · (920) 835-1100
3415 Custer St Ste D, Manitowoc, WI 54220-4328 · (920) 652-9310

Specialties and licenses

Taxonomy	Code	License
Occupational Therapist	225X00000X	4712 (WI)
Physician Assistant	363A00000X	1135070 (WI)
Physician Assistant Primary	363A00000X	3761-23 (WI)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104183516

Lacey L. Jandrin, PA-C's National Provider Identifier is 1104183516, issued on Apr 23, 2012. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Green Bay, WI. The record was last updated on Jan 30, 2023.