Edmonds, Larissa R

Edmonds, Larissa R is an individual health care provider with primary practice located at 20805 W 151St St Suite 400, Olathe KS 66061-7249. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Edmonds, Larissa R can be contacted via phone (913) 780-4900.

Contact Information

Primary practice address
20805 W 151St St Suite 400 Olathe KS 66061-7249
Fax: (913) 780-0949
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 53-76087-022 Kansas

Profile Details

NPI number 1467868133
LBN Legal business name Edmonds, Larissa R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2014
Last updated Aug 26th, 2014 - about 11 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 1467868133 NPPES
Kansas MEDICAID 201097910A

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