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General NPI Number Information
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NPI Number | 1134063647
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Entity Type | Individual
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Provider Name | LARISSA NELLIE BROTHERS DNP, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 4880 ZIEGLER RD
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City | FORT COLLINS
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State | CO
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Zip | 80528-9007
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Country | US
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Telephone | 970-591-9415
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Fax |
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Provider Business Mailing Address
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Address Line | 4483 BARROW LN
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City | TIMNATH
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State | CO
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Zip | 80547-5842
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Country | US
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Telephone | 970-290-6945
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.1001876-NP
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License Number State | CO
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