Individual
LORA MARIE MOERICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1145 W MAIN AVE, STE. 205, DE PERE, WI 54115-1698
(920) 336-6455
(920) 336-6646
Mailing address
888 THACKERAY TRL 103, OCONOMOWOC, WI 53066-4342
(262) 354-3744
(262) 354-3748
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5317
WI
Other
Enumeration date
06/21/2013
Last updated
12/16/2015
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