Individual
LARISA A. SYCHOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4922 S BELLHURST AVE, SPRINGFIELD, MO 65804-7824
(256) 343-8078
Mailing address
4922 S BELLHURST AVE, SPRINGFIELD, MO 65804-7824
(256) 343-8078
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013027044
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992147169
—
MO
05
—
420008106
—
MO
Enumeration date
07/29/2013
Last updated
09/03/2020
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