Provider Demographics
NPI:1184108763
Name:LARSEN, JOYCE LAREE (DNP)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:LAREE
Last Name:LARSEN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5240 BOULDER CT
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-5575
Mailing Address - Country:US
Mailing Address - Phone:254-640-1718
Mailing Address - Fax:
Practice Address - Street 1:6895 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3047
Practice Address - Country:US
Practice Address - Phone:303-861-7878
Practice Address - Fax:303-894-8066
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY40788.1802363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily