Individual
MS. LAREESA RENEE SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4718 N 90TH ST, MILWAUKEE, WI 53225-4906
(414) 202-6108
Mailing address
3759 N 41ST ST, MILWAUKEE, WI 53216-3044
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304260-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38279400
—
WI
Enumeration date
04/12/2008
Last updated
02/25/2022
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