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General NPI Number Information
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NPI Number | 1851542682
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Entity Type | Individual
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Provider Name | LARAE I HUYCKE PMHNP-ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1220 E 8TH ST
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City | GALENA
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State | KS
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Zip | 66739-1865
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Country | US
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Telephone | 417-658-9565
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Fax |
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Provider Business Mailing Address
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Address Line | 4784 OAK ST
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City | KANSAS CITY
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State | MO
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Zip | 64112-2262
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Country | US
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Telephone | 817-991-5951
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 741234
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61253183
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024029050
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-83532-101
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License Number State | KS
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