KIMBERLY S LARSON (NPI# 1982614723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982614723 |
| Entity Type | Individual |
| Full Name | KIMBERLY S LARSON |
| Credential | N.P. |
| Practice Address |
170 Arrowhead Dr Evanston WY 82930-9266 |
| Mailing Address |
1573 Mallory Ln Ste 100 Brentwood TN 37027-2895 |
| Practice Telephone | 3077890096 |
| Practice Fax Number | 3077890860 |
| Mailing Telephone | 6152213855 |
| Mailing Fax Number | 6152211484 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-10-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
18217.0308 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
363542-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 120048800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508406067 | Kimberly Anna Larson | Acupuncturist | 1601 2nd Ave N Ste 450h, Great Falls, MT 59401-3259 | 2020-01-13 |
| 1538688635 | Kimberly Larson | Speech-Language Pathologist | 800 Barberry Way, Joliet, IL 60431-7917 | 2017-09-11 |
| 1780003160 | Kimberly Larson | Physical Therapy Assistant | 30980 Scott Park Rd Trlr 72, Long Grove, IA 52756-9641 | 2014-04-14 |
| 1851465694 | Kimberly Rae Larson | Dietitian, Registered | 120 N 19th Ave Ste D, Bozeman, MT 59718-3920 | 2006-11-20 |
| 1972545978 | Kimberly D. Larson | Nurse Practitioner | 3170 State St, Medford, OR 97504-8450 | 2006-06-12 |
| 1215903752 | Kimberly C Larson | Physician Assistant | 2420 S Union, Ste 300, Tacoma, WA 98405-1387 | 2006-02-24 |
| 1730473885 | Kimberly Larson | Pediatrics | 747 52nd St, Oakland, CA 94609 | 2011-06-07 |
| 1033430822 | Kimberly Larson | Counselor | 404 Lincoln Blvd, Venice, CA 90291-2829 | 2010-06-16 |
| 1558546135 | Kimberly Raquell Larson | Nurse Practitioner | 7211 W Deschutes Ave, Ste D-101, Kennewick, WA 99336-7728 | 2008-01-02 |
| 1629299011 | Kimberly D Larson | Massage Therapist | 100 N Pines Rd, Spokane Valley, WA 99206-5117 | 2007-05-01 |
| Street Address |
170 ARROWHEAD DR |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744600 | Mountain Medicine LLC | Clinic/Center | 170 Arrowhead Dr, Evanston, WY 82930-9307 | 2020-06-10 |
| 1962937441 | Pain Care Center LLC | Anesthesiology | 170 Arrowhead Dr, Suite 2, Evanston, WY 82930-9307 | 2017-04-21 |
| 1124184775 | D Mckay Francom Dds | Dentist | 170 Arrowhead Dr, Suite 1, Evanston, WY 82930 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103291 | Mary Driscoll | Nurse Practitioner | 800 Austin St Ste 207, Evanston, IL 60202-3442 | 2020-08-01 |
| 1013566892 | Reba Elizabeth Mathew | Nurse Practitioner | 500 Asbury Ave # 316-3320, Evanston, IL 60202-2724 | 2019-09-05 |
| 1952768210 | Jacqueline Christie | Nurse Practitioner | 215d Dodge Ave, Evanston, IL 60202-3669 | 2016-01-18 |
| 1962873075 | Laura E Hilb | Nurse Practitioner | 2121 Dewey Ave, Evanston, IL 60201-3057 | 2015-10-14 |
| 1871982876 | Mirela Shuleva | Nurse Practitioner | 2221 Central St Apt 3e, Evanston, IL 60201-5750 | 2015-01-13 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1720303993 | Olatokunbo Olorunfemi | Nurse Practitioner | 3333 Central Street, Evanston, IL 60201-1150 | 2010-03-31 |
| 1598868689 | Mary Elizabeth Coffeen-carley | Nurse Practitioner | 831 St. Highway, 150 South, Wyoming State Hospital, Evanston, WY 82931 | 2006-09-06 |
| 1013916519 | Evanston Clinic Corp | Nurse Practitioner | 196 Arrowhead Dr Ste 8, Evanston, WY 82930-8752 | 2005-07-18 |
| 1518579739 | Rizwana Patel | Nurse Practitioner | 800 Austin St, Evanston, IL 60202-3439 | 2020-08-19 |
| Find all providers in EVANSTON | ||||
Please comment or provide details below to improve the information on KIMBERLY S LARSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.