Individual
JAMIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9640 MENAUL BLVD NE, ALBUQUERQUE, NM 87112
(866) 389-2727
Mailing address
9640 MENAUL BLVD NE, ALBUQUERQUE, NM 87112-2217
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55543
NM
363LF0000X
Family Nurse Practitioner
76474
KS
363LF0000X
Family Nurse Practitioner
APRN01427
RI
Other
Enumeration date
08/17/2014
Last updated
05/03/2019
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