Individual
MRS. MAKENZIE SUE LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
352 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703
(573) 275-6446
(573) 313-3713
Mailing address
352 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703
(573) 275-6446
(573) 313-3713
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2017027611
MO
363L00000X
Nurse Practitioner
2017027611
MO
Other
Enumeration date
12/14/2017
Last updated
12/01/2025
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