| NPI | 1487817912 |
|---|---|
| Former Name | ANDREA L LARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001014) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 1809) |
| 363L00000X Nurse Practitioner (Licence: MN r190270-9) | |
| 363L00000X Nurse Practitioner (Licence: AZ 257010) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 257010) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2023-09-29 |