Individual
SHANNAN NICOLE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
404 JEFFERSON ST, PELLA, IA 50219
(641) 628-6634
(641) 621-2458
Mailing address
PO BOX 843032, KANSAS CITY, MO 64184-3032
(913) 642-4900
(913) 381-0979
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
133501
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
D133501
IA
Other
Enumeration date
04/24/2014
Last updated
10/29/2024
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