Provider Demographics
NPI:1225399561
Name:JUAREZ BEARD, LAURETTE LYN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURETTE
Middle Name:LYN
Last Name:JUAREZ BEARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 N CLAREMONT DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-1301
Mailing Address - Country:US
Mailing Address - Phone:608-756-4967
Mailing Address - Fax:
Practice Address - Street 1:1033 N CLAREMONT DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-1301
Practice Address - Country:US
Practice Address - Phone:608-756-4967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI174374-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health