Individual
JOHN S LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
Mailing address
102 FINSBURY LN, LAFAYETTE, LA 70506
(337) 344-1406
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
204085
LA
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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