Individual
MISS JODY LYNNE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
934 S MAIN ST, LAYTON, UT 84041
(801) 773-7060
Mailing address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
7352093-3102
UT
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
7352093-3102
UT
Other
Enumeration date
06/15/2010
Last updated
04/25/2019
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