Individual
RAESHELLE JANE LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1811 W 400 N, OGDEN, UT 84404-3416
(801) 721-5268
Mailing address
1811 W 400 N, OGDEN, UT 84404-3416
(801) 721-5268
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
10511134-3102
UT
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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