Individual
SARA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2705 E 17TH ST, AMMON, ID 83406-6601
(208) 346-7500
Mailing address
1209 W 5000 N, REXBURG, ID 83440-3204
(208) 249-1974
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
N-42254
ID
Other
Enumeration date
06/16/2023
Last updated
08/07/2023
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