Jill J Larsen, RN
Registered Nurse in Provo, UT. Individual provider (NPI-1).
NPI number1760655690
StatusActive
Last updated in NPPESApr 11, 2008
Details
- NPI
- 1760655690
- Entity type
- Individual (NPI-1)
- Name
- Jill J Larsen
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2008
- Last updated
- Apr 11, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 60862043102 | UT | Yes |
Practice location
151 S University Ave # 1900Provo, UT 84601-4427
Phone 801-851-7047 · Fax 801-851-7055
Mailing address
151 S University Ave # 1900Provo, UT 84601-4427
Phone 801-851-7047 · Fax 801-851-7055
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