Individual
MIKALA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1380 S MEDICAL CENTER DR., SAINT GEORGE, UT 84790
(435) 251-1939
Mailing address
1167 E 400 S UNIT 26, SAINT GEORGE, UT 84790-5773
(435) 680-0792
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8500357-4405
UT
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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