Larson, Kirt W

Larson, Kirt W is an sole proprietor health care provider with primary practice located at 13352 South 5600 West , Herriman UT 84096. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Larson, Kirt W can be contacted via phone (801) 446-2760.

Contact Information

Primary practice address
13352 South 5600 West Herriman UT 84096
Phone: (801) 446-2760
Fax: (801) 446-2762
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 211451-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2114514405 Utah

Profile Details

NPI number 1053576504
LBN Legal business name Larson, Kirt W
Credentials MSN,FNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 24th, 2008
Last updated Oct 13th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053576504 NPPES
Utah MEDICAID 1053576504

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