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Individual

DILAROM ST LOUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
930 E WALL ST, EAGLE RIVER, WI 54521-9368
(715) 477-3000
Mailing address
6728 WHITEFISH LAKE RD, THREE LAKES, WI 54562-9340
(715) 614-0621

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16087-33
WI
363LF0000X
Family Nurse Practitioner
16087-33
WI

Other

Enumeration date
09/05/2024
Last updated
10/22/2024
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