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Individual

MRS. ATHENA LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
155 HOSPITAL DR, SUITE 410, LAFAYETTE, LA 70503-2852
(337) 289-9700
(337) 289-9702
Mailing address
155 HOSPITAL DR, SUITE 410, LAFAYETTE, LA 70503-2852
(337) 289-9700
(337) 289-9702

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP04546
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP05456
LICENSE
LA
Enumeration date
04/30/2008
Last updated
07/30/2014
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