Provider Demographics
NPI:1366782716
Name:LARSEN, ALEXANDRA CINDY (FNP)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:CINDY
Last Name:LARSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 PARAMONT ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-7168
Mailing Address - Country:US
Mailing Address - Phone:541-941-8748
Mailing Address - Fax:
Practice Address - Street 1:2614 ALMOND ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1117
Practice Address - Country:US
Practice Address - Phone:541-885-2201
Practice Address - Fax:541-883-1400
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201350033NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily