Lacey L Jandrin
PA-C | Occupational Therapist | 10+ years Exp
1970 S Ridge Rd, Green Bay
Wisconsin, 54304-4125
920-430-4888 920-430-4889
Maps & DirectionsLacey L Jandrin is a Green Bay, Wisconsin based therapist with 10 years of experience in Occupational Therapy. She completed her graduation from University Of North Dakota School Of Medicine in 2016. She is also affiliated with hospitals like and . She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Lacey L Jandrin is 3761-23 for Occupational Therapy in Wisconsin. Her current practice location is 1970 S Ridge Rd, Green Bay. Patients can reach her at 920-430-4888 or can fax her at 920-430-4889. Lacey L Jandrin is PA-C in Occupational Therapy and her NPI number (Unique professional ID assigned by NPPES) is 1104183516.
Lacey L Jandrin provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction.
Complete Profile:
Lacey L Jandrin speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Lacey L Jandrin |
| Specialization: | Occupational Therapy |
| Gender: | Female |
| Credentials: | PA-C |
| Experience: | 10+ years |
| Medical School Attended: | University Of North Dakota School Of Medicine |
| Graduation Year: | 2016 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1970 S Ridge Rd, Green Bay, Wisconsin, 54304-4125 |
| Phone: | 920-430-4888 |
| Fax: | 920-430-4889 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 8820380132 |
| Enrollment ID: | I20160707000393 |
| NPI Number: | 1104183516 |
| NPI Enumeration Date: | 23 Apr, 2012 |
| NPI Last Update On: | 30 Jan, 2023 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lacey L Jandrin are as mentioned below.
| License Number | Specialization | State | Status | |
| 3761-23 | Occupational Therapy | Wisconsin | Primary | |
| 4712 | Occupational Therapy | Wisconsin | Secondary | |
| 1135070 | Physician Assistant | Wisconsin | Secondary | |
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
| Hospital Name (CCN) | State | Hospital Type |
| (520193) | Green bay, WI | Acute Care Hospital |
| (520034) | Two rivers, WI | Acute Care Hospital |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Lacey L Jandrin is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Baycare Clinic Llp (4385554328) | 175 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Lacey L Jandrin such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1135070 | Other | | NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Lacey L Jandrin Po Box 22487, Green Bay, Wisconsin |
| Zip: | 54305-2487 |
| Phone Number: | 920-445-7210 |
| Fax Number: | 920-445-7289 |
Patients can reach Lacey L Jandrin at
1970 S Ridge Rd, Green Bay, Wisconsin or can
call to book an appointment on 920-430-4888.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 March, 2026.