Most Relevant Information
Provider Data
| NPI Number: | 1003323304 |
| Provider Name: | KAYLENE NICHOLE LARSON APRN, CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 2163 |
Most Important Dates
| Enumeration Date: | 01/08/2018 |
| Last Updated: | 08/16/2023 |
Provider Practice Location
301 BECKER AVE SW
WILLMAR
MN
562013302
Practice Location Phone/Fax
| Phone: | 3202354543 |
| Fax: |
Provider Mailing Location
4161 18TH AVE S APT 117
FARGO
ND
581037416
Provider Mailing Phone/Fax
| Phone: | 7012122396 |
| Fax: |