Provider Demographics
NPI:1841238243
Name:LARSON, CYNTHIA (CINDY) DEAN (MSN, RN, BC, FNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA (CINDY)
Middle Name:DEAN
Last Name:LARSON
Suffix:
Gender:F
Credentials:MSN, RN, BC, FNP
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:DEAN
Other - Last Name:SELBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:403 WOODLAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-8798
Mailing Address - Country:US
Mailing Address - Phone:620-223-8040
Mailing Address - Fax:620-223-8002
Practice Address - Street 1:900 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:KS
Practice Address - Zip Code:66075-4078
Practice Address - Country:US
Practice Address - Phone:913-352-8379
Practice Address - Fax:913-352-8998
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45518363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner