Individual
KACI RAE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 N 12TH ST STE 404, PHOENIX, AZ 85006-2866
(800) 233-3264
Mailing address
25500 N NORTERRA DR, PHOENIX, AZ 85085-8200
(623) 277-2370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2018044700
MO
207Q00000X
Family Medicine Physician
Primary
64070
AZ
Other
Enumeration date
06/17/2016
Last updated
02/09/2026
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