Provider Demographics
NPI:1730079120
Name:HARROD, LAUREN GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GRACE
Last Name:HARROD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6970 PINE SISKIN PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-8904
Mailing Address - Country:US
Mailing Address - Phone:608-556-3033
Mailing Address - Fax:
Practice Address - Street 1:340 S WHITNEY WAY STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-4631
Practice Address - Country:US
Practice Address - Phone:608-709-8089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8480-23207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine