Individual
CARLENE LAVERNE OHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
23814 STATE HIGHWAY T, EXCELLO, MO 65247-2002
(573) 489-0732
Mailing address
23814 STATE HIGHWAY T, EXCELLO, MO 65247-2002
(573) 489-0732
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043529
MO
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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