Individual
JOHANNA BROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28803 450TH ST, LAPORTE, MN 56461-4812
(218) 407-2376
Mailing address
28803 450TH ST, LAPORTE, MN 56461-4812
(218) 407-2376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R-193263-0
MN
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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