Individual
MRS. GRACE GAR YUN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041374899
IL
176B00000X
Midwife
209011927
IL
367A00000X
Advanced Practice Midwife
Primary
209011927
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209011927
STATE LICENSE
IL
01
—
309017757
CS LICENSE
IL
Enumeration date
10/01/2014
Last updated
03/07/2023
Update your record
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