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General NPI Number Information
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NPI Number | 1578360699
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Entity Type | Individual
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Provider Name | JOHN MURRAY LARSEN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 6936 S PROMENADE DR STE 202
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-3387
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Country | US
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Telephone | 801-605-3801
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Fax | 801-752-3068
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Provider Business Mailing Address
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Address Line | 968 CHAMBERS ST STE 5
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City | OGDEN
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State | UT
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Zip | 84403-5082
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Country | US
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Telephone | 801-605-3801
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 7947701-8900
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 7947701-3102
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License Number State | UT
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