Individual
ASHLEY LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(770) 979-0200
(678) 352-4322
Mailing address
1600 MEDICAL WAY STE 100, SNELLVILLE, GA 30078-2159
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN223430
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003215404C
—
GA
Enumeration date
10/26/2017
Last updated
09/09/2022
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