# LAURIE DENISE LARSEN

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

## Provider details

- **NPI number:** 1780685859
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 7216 | NV | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 07/25/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 20-19282 | — | NV |
| 01 | — | 483864 | MEDICAID ARIZONA | AZ |