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Raegan Rene Tervort
Student in an Organized Health Care Education/Training Program in La Crosse, Wisconsin
NPI 1548703473

Raegan Rene Tervort is a Student in an Organized Health Care Education/Training Program based in Oregon, WI. Raegan Rene Tervort practices in La Crosse, WI. The NPI Number for Raegan Rene Tervort is 1548703473 and holds a License No. (Wisconsin).

The current practice location address for Raegan Rene Tervort is 1725 State St, La Crosse, WI and can be reached out via phone at 608-785-8000.

Location: 1725 State St, La Crosse, WI, 53575-3805
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548703473
Provider Name
Raegan Rene Tervort
Credential
Provider Entity Type
Individual
Gender
Female
Address
1725 State St, La Crosse, WI, 53575-3805
Phone Number
608-785-8000
Fax Number
Provider Enumeration Date
11/26/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1725 State St
City
La Crosse
State
Wisconsin
Zip
54601-3742
Phone Number
608-785-8000
Fax Number
person
Provider Business Mailing Address Details
Address
1725 State St
City
La Crosse
State
Wisconsin
Zip
54601-3742
Phone Number
608-785-8000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Wisconsin)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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