Provider Demographics
NPI:1568188068
Name:LARSON, SARAH (APRN)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:LARSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 S MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3544
Mailing Address - Country:US
Mailing Address - Phone:785-242-1620
Mailing Address - Fax:
Practice Address - Street 1:12200 W 106TH ST STE 125
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2382
Practice Address - Country:US
Practice Address - Phone:913-599-1396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2021209649207Q00000X
KS53-81360-032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine