Doctor Name: | NANCY H LARSON |
NPI Number: | 1487999017 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | F306240-1 |
Business Practice Address: | 997 Glen Cove Ave Glen Head, NY - 115451593 |
Business Phone Number: | 5166749144 |
Business Fax Number: | |
Mailing Address: | 160 Eakins Rd, MANHASSET |
State: | NY |
Postal Code: | 110302636 |
Phone Number: | 5163659665 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2012 |
NPI Last Update Date: | 12/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F306240-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |