Individual
CATHERINE ROSE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
12750 ST FRANCIS DR STE 320, CROWN POINT, IN 46307-0264
(219) 662-0077
(219) 662-9496
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71009690A
IN
363LF0000X
Family Nurse Practitioner
209014104
IL
Other
Enumeration date
06/04/2016
Last updated
01/12/2024
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