Individual
MRS. NICOLE ELIZABETH LARVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 WYOMING ST, DAYTON, OH 45409-2711
(937) 208-8000
Mailing address
3170 KETTERING BLVD, BUILDING B 3RD FLOOR, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN288497
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.024609
OH
363LG0600X
Gerontology Nurse Practitioner
APRN.CNP.024609
OH
Other
Enumeration date
11/12/2018
Last updated
05/13/2019
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