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Individual

NINA LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 RIVER DR, FORT BRAGG, CA 95437-5403
(707) 961-1234
Mailing address
700 RIVER DR, FORT BRAGG, CA 95437-5403
(707) 961-1234

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
95064465
CA

Other

Enumeration date
07/28/2025
Last updated
07/28/2025
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