Provider Demographics
NPI:1922572783
Name:WERRLINE, LAURIE L (LPN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:L
Last Name:WERRLINE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W5759 MINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-9795
Mailing Address - Country:US
Mailing Address - Phone:608-293-1583
Mailing Address - Fax:
Practice Address - Street 1:W5759 MINGS RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-9795
Practice Address - Country:US
Practice Address - Phone:608-293-1583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316839310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility