Mackenzie A Larson
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fort Lupton, CO
NPI 1477218014 · NPPES record last updated Nov 8, 2021
Key facts
- NPI
- 1477218014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 218 4TH St
Fort Lupton, CO 80621-2016 - Phone
- (303) 710-0903
- NPI assigned
- Nov 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
218 4TH St
Fort Lupton, CO 80621-2016
Mailing address
218 4TH St
Fort Lupton, CO 80621-2016
Phone (303) 710-0903
Other providers in Fort Lupton, CO
- Sarah Kirby Johnson
- Anthony Johnston
- Krista Rae Juth
- Michelle Kaiser
- Toni Kooy
- Veronica T Lechuga
- Stephanie Linskens
- Josue Lopez
- Donesha L Lujan
- Jaime Macelroy
All providers in Fort Lupton, CO · Student in an Organized Health Care Education/Training Program in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.