| NPI | 1912426958 |
|---|---|
| Former Name | SHANNA L LARSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 13612-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 165844) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 13612-33) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 13612-33) | |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2024-05-03 |