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General NPI Number Information
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NPI Number | 1952362956
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Entity Type | Individual
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Provider Name | RUTH S LARSON NP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 620 10TH ST STE. 703
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1841
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Country | US
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Telephone | 716-278-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 908 NIAGARA FALLS BLVD SUITE 208
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-2019
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Country | US
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Telephone | 716-692-3302
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Fax | 716-692-4342
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F303989
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License Number State | NY
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