Provider Type Icon

BRANDY LEE LARSON FNP NPI 1730652280


NPI Information

NPI: 1730652280
Provider Name: BRANDY LEE LARSON, FNP
Classification: Obstetrics & Gynecology - 207VX0201X
Entity Type: Individual

Specialization: Gynecologic Oncology

PECOS Registration: Yes

Address:
808 PANCHERI DR
IDAHO FALLS, ID
ZIP 83402
Phone: (208) 557-2900
Get Directions

Brandy Lee Larson, FNP is a gynecologic oncology obstetrics gynecology in Idaho Falls, ID with 6 years of experience. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. Brandy Lee Larson, FNP NPI is 1730652280. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

808 PANCHERI DR
IDAHO FALLS, ID
ZIP 83402-344
Phone: (208) 557-2900
Fax: (208) 557-2910

The NPI 1730652280 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Testing for presence of drug (HCPCS:80305)

The enumeration date for this NPI number is 1/8/2019 and was last updated on 10/31/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse Practitioner60357IDAHONo
2207VX0201XObstetrics & GynecologyGynecologic OncologyCNP60357IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11730652280MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.