Individual
KARISSA LOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14222 TAUS RD, REEDSVILLE, WI 54230-8162
(920) 973-4027
Mailing address
14222 TAUS RD, REEDSVILLE, WI 54230-8162
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
325186
WI
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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