# LARESA ALEXIS SHANAE OWENS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104548536
- **Gender:** F
- **Credential:** CNA, CBRF

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 374U00000X | Home Health Aide | 00197312 | WI | — |
| 376K00000X | Nurse's Aide | WI031910101915 | WI | Yes |

## Other

- **Enumeration date:** 09/13/2022
- **Last updated:** 09/13/2022