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NPI Code Detail

MEDICARE: AYANNA LARSON RN

MEDICARE: AYANNA LARSON RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1467381061
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYANNA LARSON RN
Provider Business Mailing Address
First Line : PO BOX 1661
Second Line :
City : EAST HELENA
State : MT
Zip : 59635-1661
Country : US
Telephone Number : 406-439-8112
Fax Number :
Provider Business Practice Location Address
First Line : 2475 E BROADWAY ST
Second Line :
City : HELENA
State : MT
Zip : 59601-4928
Country : US
Telephone Number : 406-457-4180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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