Provider Demographics
NPI:1184705089
Name:LARSEN, LINDA F (RN NP-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:LARSEN
Suffix:
Gender:F
Credentials:RN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3190 ANTILLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5015
Mailing Address - Country:US
Mailing Address - Phone:325-672-5603
Mailing Address - Fax:325-672-6570
Practice Address - Street 1:3190 ANTILLEY ROAD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5015
Practice Address - Country:US
Practice Address - Phone:325-672-5603
Practice Address - Fax:325-672-6570
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX249167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125211OtherSUPERIOR HEALTH PLAN
TX500010719OtherRAILROAD MEDICARE
TX117408100OtherFIRST CARE
TX7678149OtherAETNA
TX82N680OtherBLUECROSS BLUESHIELD
TX8Y3209OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX092919201Medicaid
TX8Y3209OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX500010719OtherRAILROAD MEDICARE
TX092919201Medicaid