NPI 1568465300 · live from the CMS NPI Registry
Kevin J Larsen, DPM
Podiatrist, Foot & Ankle Surgery in Grand Island, NE. National Provider Identifier 1568465300, active.
NPI record
| NPI | 1568465300 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 620 N Diers Ave Ste 100, Grand Island, NE 68803 |
| Practice phone | 308-381-0404 |
| Mailing address | Po Box 5020, Grand Island, NE 68802 |
| Enumerated | May 24, 2005 |
| Last updated | March 12, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 231 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.