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Individual
KEVIN J LARSEN
Active
Individual
KEVIN J LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
231
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0152470001
DMERC CIGNA
NE
01
—
02554
BLUE CROSS BLUE SHIELD
NE
01
—
280176
MEDICARE
NE
01
—
470624979
CHAMPUS
NE
05
—
47062497913
—
NE
01
—
480021904
RAILROAD MEDICARE
NE
Enumeration date
05/24/2005
Last updated
03/12/2018
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