Individual
JENNIFER LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8533 E 32ND ST N, WICHITA, KS 67226-2611
(316) 293-2622
(855) 517-9494
Mailing address
PO BOX 1358, WICHITA, KS 67201-1358
(316) 293-3429
(855) 495-3229
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15-00679
KS
Other
Enumeration date
08/07/2006
Last updated
12/31/2014
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