Individual provider · Type 1 NPI
Brandy Lee Larson, FNP
Gynecologic Oncology Physician · Idaho Falls, ID
Practice location
808 Pancheri Dr
Idaho Falls, ID 83402-3344
Fax (208) 557-2910
Mailing address
3450 Potomac Way
Idaho Falls, ID 83404-4970
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 60357 (ID) |
| Gynecologic Oncology Physician Primary | 207VX0201X | CNP60357 (ID) |
Gynecologic Oncology Physician: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
Another provider at this address
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About NPI 1730652280
Brandy Lee Larson, FNP's National Provider Identifier is 1730652280, issued on Jan 8, 2019. The primary taxonomy on file is Gynecologic Oncology Physician (207VX0201X), and the practice location is in Idaho Falls, ID. The record was last updated on Oct 31, 2022.