BRANDY LEE LARSON FNP
Individual Provider (NPI-1)
Active
Obstetrics & Gynecology, Gynecologic Oncology
Provider Information
- NPI Number
1730652280- Provider Type
- Individual Provider (NPI-1)
- Credentials
- FNP
- Status
- Active
Contact & Location
- Address
- 808 PANCHERI DR, IDAHO FALLS, ID, 834023344
- Phone
- (208) 557-2900
- Fax
- (208) 557-2910
Specialties & Taxonomies
Nurse Practitioner
License: ID #60357
Obstetrics & Gynecology, Gynecologic Oncology
Primary License: ID #CNP60357