Individual
KAYLA RAE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1898 FORT RD, SHERIDAN, WY 82801-8320
(307) 672-3473
Mailing address
18 BREWSTER LN, BIRNEY, MT 59012-9502
(307) 752-1983
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
8545
WY
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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