Provider Demographics
NPI:1366811689
Name:LAMBEAU, MEGAN MARJORIE (F-NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARJORIE
Last Name:LAMBEAU
Suffix:
Gender:F
Credentials:F-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:744 S WEBSTER AVE 7TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3505
Mailing Address - Country:US
Mailing Address - Phone:920-433-7864
Mailing Address - Fax:920-433-6090
Practice Address - Street 1:2741 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3833
Practice Address - Country:US
Practice Address - Phone:715-732-1392
Practice Address - Fax:715-732-1393
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6625-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400243720Medicare Oscar/Certification
WIK400254166Medicare Oscar/Certification