Individual
LARISA ANATOLYEVNA DYAKOVA
Active
Individual
LARISA ANATOLYEVNA DYAKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
79627
NM
363LF0000X
Family Nurse Practitioner
0032705
OH
Other
Enumeration date
02/14/2023
Last updated
11/18/2024
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