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Individual

DEBORAH KAY LAROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
207 HAYSTACK LANE, ELKHORN, WI 53121-0754
(262) 723-5000
Mailing address
P.O. BOX 890, NEW MUNSTER, WI 53152-0890
(262) 903-9295

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38317100
WI
Enumeration date
05/01/2007
Last updated
07/08/2007
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