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Individual
KIMBERLIE LARSON
Active
Individual
KIMBERLIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
R38487
ND
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
12948
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202733
ND
Other
Enumeration date
09/23/2024
Last updated
08/13/2026
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