Individual
KELLY KRISTINE PARISH-LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
3500 TOWER AVE, ESSENTIA HEALTH ST. MARY'S SUPERIOR CLINIC, SUPERIOR, WI 54880-5335
(715) 395-5454
Mailing address
3500 TOWER AVE, ESSENTIA HEALTH ST. MARY'S SUPERIOR CLINIC, SUPERIOR, WI 54880-5335
(715) 395-5454
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
193379-30
WI
363LF0000X
Family Nurse Practitioner
Primary
5377-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316386998
—
MN
05
—
1316386998
—
WI
Enumeration date
06/18/2013
Last updated
10/23/2020
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