Individual
LARINA BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3700 W 203RD ST STE 301, OLYMPIA FIELDS, IL 60461-1182
(708) 679-2850
(708) 503-3816
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209014322
IL
Other
Enumeration date
06/01/2016
Last updated
03/22/2024
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