Individual
DR. KINDRA ANNE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
825 FAIRFAX AVE, SUITE 310, NORFOLK, VA 23507-1914
(757) 446-7900
(757) 624-2254
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-7900
(757) 624-2254
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101247346
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-010
TRICARE/CHAMPUS
VA
01
—
10059924
OPTIMA HEALTH
VA
05
—
1467461038
—
VA
01
—
409628
ANTHEM BC/BS
VA
05
—
5914944
—
NC
01
—
PAR
FIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VA
Enumeration date
08/05/2006
Last updated
11/21/2011
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