Healthcare Provider Details

I. General information

NPI: 1013354018
Provider Name (Legal Business Name): KENDRA L LARSEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W. 1ST STREET TRINITY COMMUNITY CLINIC-VELVA
VELVA ND
58790-0070
US

IV. Provider business mailing address

PO BOX 5010
MINOT ND
58702-5010
US

V. Phone/Fax

Practice location:
  • Phone: 701-338-2066
  • Fax: 701-338-2048
Mailing address:
  • Phone: 701-857-5650
  • Fax: 701-857-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR29381
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR29381
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: