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Individual

MRS. LORENNA WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3221 S LAKE DR, ST FRANCIS, WI 53235-3702
(414) 372-9486
Mailing address
3221 S LAKE DR, ST FRANCIS, WI 53235-3702
(414) 372-9486

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
31836-31
WI

Other

Enumeration date
09/06/2012
Last updated
09/06/2012
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