Provider Demographics
NPI:1720592082
Name:SCOTT, LARISA CLAIRE (APRN)
Entity Type:Individual
Prefix:
First Name:LARISA
Middle Name:CLAIRE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15710 W. 135TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1511
Mailing Address - Country:US
Mailing Address - Phone:913-297-7472
Mailing Address - Fax:913-764-0336
Practice Address - Street 1:15710 W. 135TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1511
Practice Address - Country:US
Practice Address - Phone:913-297-7472
Practice Address - Fax:913-764-0336
Is Sole Proprietor?:No
Enumeration Date:2017-11-24
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2022006500363LF0000X
KS77942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily