Individual
INGRID A LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
3101 BROADWAY, KANSAS CITY, MO 64111
(816) 960-8040
(816) 960-3084
Mailing address
3101 BROADWAY, KANSAS CITY, MO 64111
(816) 960-8040
(816) 960-3084
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2007033875
MO
363LP0200X
Pediatric Nurse Practitioner
46276
KS
Other
Enumeration date
09/03/2008
Last updated
10/31/2014
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