Individual
LAURIE A DEMRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-3388
(920) 288-3370
Mailing address
2845 GREENBRIER RD, PO BOX 8900, GREEN BAY, WI 54308-8900
(920) 288-3388
(920) 288-3370
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
87931
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104510737
MEDICAID
MI
01
—
104510746
MEDICIAD
MI
05
—
44322300
—
WI
01
—
P00093633
RAILROAD
WI
Enumeration date
08/12/2006
Last updated
11/17/2022
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