MEDICARE: LARISA KAY ONG APRN-NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	116621	NE
2	163W00000X	Registered Nurse	70592	NE

General Provider Information

NPI Number	:	1891668836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARISA KAY ONG APRN-NP

Provider Business Mailing Address
First Line	:	43201 ROAD 762
Second Line	:
City	:	LEXINGTON
State	:	NE
Zip	:	68850-3718
Country	:	US
Telephone Number	:	308-325-5032
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 12TH ST
Second Line	:
City	:	COZAD
State	:	NE
Zip	:	69130-1532
Country	:	US
Telephone Number	:	308-784-2261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2025
Last Update Date	:	01/29/2026

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