Individual
LARESA ALEXIS SHANAE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA, CBRF
Contact information
Practice address
3422 N 2ND ST, MILWAUKEE, WI 53212-1557
(414) 737-1042
Mailing address
6629 W CHARLES CT, FRANKLIN, WI 53132-9268
(414) 737-1042
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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