Individual
LAURIE B DEBARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5951
(414) 777-0044
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-5951
(414) 777-0044
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
70872030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44334300
—
WI
Enumeration date
05/15/2006
Last updated
01/25/2016
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