Mikala Larsen
Nurse Practitioner in Saint George, UT. Individual provider (NPI-1).
NPI number1962053017
StatusActive
Last updated in NPPESSep 20, 2019
Details
- NPI
- 1962053017
- Entity type
- Individual (NPI-1)
- Name
- Mikala Larsen
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 20, 2019
- Last updated
- Sep 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 8500357-4405 | UT | Yes |
Practice location
1380 S Medical Center Dr.Saint George, UT 84790
Phone 435-251-1939
Mailing address
1167 E 400 S Unit 26Saint George, UT 84790-5773
Phone 435-680-0792
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