Individual
JENNIFER K LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1414 W 4TH ST, GILLETTE, WY 82716-3328
(307) 682-6263
(307) 682-2024
Mailing address
1414 W 4TH ST, GILLETTE, WY 82716-3328
(307) 682-6263
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
21839.1370
WY
207V00000X
Obstetrics & Gynecology Physician
Primary
21839.1370
WY
Other
Enumeration date
09/27/2017
Last updated
07/21/2022
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