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Individual

MRS. ALYSSA IRENE LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP. APRN, FNP-C

Contact information

Practice address
10 S 2000 E, SALT LAKE CITY, UT 84112-5880
(801) 662-8801
Mailing address
555 FOOTHILL DR, SALT LAKE CITY, UT 84112-1106
(801) 581-6431

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9806303-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9806303-4405
ADVANCED PRACTICE REGISTERED NURSE
UT
Enumeration date
06/13/2022
Last updated
09/21/2023
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