Individual
MARY ELIZABETH LARSON-BRENDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
14104 S ST, OMAHA, NE 68137-2636
(402) 614-7385
Mailing address
122 N 8TH ST, MISSOURI VALLEY, IA 51555-1718
(402) 680-2546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
111473
NE
363LF0000X
Family Nurse Practitioner
A089499
IA
Other
Enumeration date
03/08/2013
Last updated
05/06/2017
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