Individual
MRS. LARINE BURROUGHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1157 13TH AVE, GREEN BAY, WI 54304-2537
(920) 494-3310
Mailing address
1157 13TH AVE, GREEN BAY, WI 54304-2537
(920) 494-3310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
91790-30
WI
Other
Enumeration date
05/06/2010
Last updated
05/06/2010
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