Individual
LAURA REAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3290
Mailing address
PO BOX 62, JEFFERSON, SD 57038-0062
(210) 823-8059
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D143572
IA
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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