Individual
MAIKHOU LOR HER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
214 S FORREST ST STE L1, STOUGHTON, WI 53589-1713
(608) 889-7400
Mailing address
2754 BURRITT RD, STOUGHTON, WI 53589-3383
(608) 556-6681
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
251098-30
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/31/2019
Last updated
10/27/2020
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