Individual
LARISSA R EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20805 W 151ST ST, SUITE 400, OLATHE, KS 66061-7249
(913) 780-4900
(913) 780-0949
Mailing address
20805 W 151ST ST, SUITE 400, OLATHE, KS 66061-7249
(913) 780-4900
(913) 780-0949
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-76087-022
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201097910A
—
KS
Enumeration date
07/02/2014
Last updated
08/26/2014
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