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Individual
LARESA ALEXIS SHANAE OWENS
Active
Individual
LARESA ALEXIS SHANAE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA, CBRF
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
00197312
WI
376K00000X
Nurse's Aide
Primary
WI031910101915
WI
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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