# MR. DAVID LARS CHRISTIAN JOHNSRUD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063152791
- **Gender:** Man
- **Credential:** BA, MAC, BSN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP2201X | Ambulatory Care Registered Nurse | 60607354 | WA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RNP289863 | AZ | Yes |

## Other

- **Enumeration date:** 03/30/2022
- **Last updated:** 10/16/2023