Individual
JOHN KENYON LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1155 MILL ST, RENO, NV 89502-1576
(775) 982-5000
(775) 982-3900
Mailing address
1155 MILL ST, MS M-14, RENO, NV 89502-1576
(775) 982-5262
(775) 982-3900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110003922
VA
363A00000X
Physician Assistant
Primary
PA2016
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538422118
—
VA
Enumeration date
06/19/2012
Last updated
02/26/2026
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