Makenzie Sue Larose, NP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2017027611 Issued in MO

Practice address

352 S Broadview St
Cape Girardeau, MO 63703

Phone

(573) 275-6446

Fax

(573) 313-3713

NPI assigned

Dec 14, 2017

Last updated

Dec 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1881100766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63703",
            "telephone_number": "573-275-6446",
            "fax_number": "573-313-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63703",
            "telephone_number": "573-275-6446",
            "fax_number": "573-313-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "MAKENZIE",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2017027611",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2017027611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Michelle Lane, RN, BSN, FNP-C
• Marshell Lane, NURSE
• Aaron Lang, M.D.
• Jennifer Lang, APN, CNM
• Lana Dalton Lange, PT
• Daphne Marie Larson
• Charles J Lastrapes, DO
• Laura E. Holmes, M.D., L.L.C.
• Charles E Lavalle, M.D.
• Lee C Lavalle, CRNA

• Family Medicine Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.