| NPI | 1063032316 |
|---|---|
| Other Name | TRACY LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23497) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO 0101760) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2025-01-09 |