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Individual

BRENDA LEE LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
15132 E HAMPDEN AVE STE G, AURORA, CO 80014-5038
(303) 360-6276
Mailing address
3701 S BROADWAY, ENGLEWOOD, CO 80113-3611
(303) 360-6276
(303) 761-2787

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
105593
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83280839
CO
01
CO306791
MEDICARE
Enumeration date
02/07/2006
Last updated
02/08/2019
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