Individual
KIRT W LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN,FNP-C
Contact information
Practice address
13352 SOUTH 5600 WEST, HERRIMAN, UT 84096
(801) 446-2760
(801) 446-2762
Mailing address
13352 SOUTH 5600 WEST, HERRIMAN, UT 84096
(801) 446-2760
(801) 446-2762
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
211451-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
2114514405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053576504
—
UT
Enumeration date
07/24/2008
Last updated
10/13/2022
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