Provider Demographics
NPI:1528003878
Name:LARSON, BARBARA ANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:LARSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13279 NORTH ROSS LANE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:KS
Mailing Address - Zip Code:66075
Mailing Address - Country:US
Mailing Address - Phone:913-352-8223
Mailing Address - Fax:
Practice Address - Street 1:11729 ROE AVE
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-2605
Practice Address - Country:US
Practice Address - Phone:913-345-8404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO141541363LF0000X
KS44994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO141541OtherAPRN