Individual
LANAH W LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1543 KINGSLEY AVE, BLDG 14, ORANGE PARK, FL 32073-4535
(904) 264-6977
(904) 269-0870
Mailing address
1543 KINGSLEY AVE, BLDG 14, ORANGE PARK, FL 32073-4535
(904) 264-6977
(904) 269-0870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 663182
FL
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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