Provider Demographics
NPI:1447503610
Name:LAGANIERE, ANISSA CHENON (RNBSN)
Entity type:Individual
Prefix:
First Name:ANISSA
Middle Name:CHENON
Last Name:LAGANIERE
Suffix:
Gender:F
Credentials:RNBSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28883 RUSTIC VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-6711
Mailing Address - Country:US
Mailing Address - Phone:608-475-3412
Mailing Address - Fax:
Practice Address - Street 1:28883 RUSTIC VILLAGE LN
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-6711
Practice Address - Country:US
Practice Address - Phone:608-475-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19023630163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical