Individual
KIRSTEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1741 SE LORRAINE ST, PORT ST LUCIE, FL 34952-6540
(772) 337-3490
Mailing address
1741 SE LORRAINE ST, PORT ST LUCIE, FL 34952-6540
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5149861
FL
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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