Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lanie E Johnson, PAC

Individual provider Physician Assistant · NPI 1639665763

Lanie E Johnson, PAC is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2019, 7 years ago. Practices with The Medical College of Wisconsin Inc, a 2,093-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2018
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone: (414) 955-0350
Fax: (414) 805-6864
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4853 (WI)

Record details

NPI number1639665763
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedJuly 1, 2018
Last updated in NPPESMarch 22, 2023
Certification dateMarch 22, 2023
Mailing address9200 W Wisconsin Ave, Milwaukee, WI 53226-3522

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice The Medical College Of Wisconsin Inc — 2093 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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