Provider Demographics
NPI:1093274425
Name:JAMES, LARONDA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LARONDA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9697 SAINT CATHERINES DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-2118
Mailing Address - Country:US
Mailing Address - Phone:262-656-3338
Mailing Address - Fax:262-656-3368
Practice Address - Street 1:9697 SAINT CATHERINES DR
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-2118
Practice Address - Country:US
Practice Address - Phone:262-656-3338
Practice Address - Fax:262-656-3368
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9146-33363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily