Provider Demographics
NPI:1821445677
Name:LARSEN, KAREN LEIGH (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEIGH
Last Name:LARSEN
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 1:535 S FREEBORN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KS
Mailing Address - Zip Code:66861-1256
Mailing Address - Country:US
Mailing Address - Phone:316-258-4969
Mailing Address - Fax:
Practice Address - Street 1:535 S FREEBORN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KS
Practice Address - Zip Code:66861-1256
Practice Address - Country:US
Practice Address - Phone:316-258-4969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-77240363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner