Provider Demographics
NPI:1891668836
Name:ONG, LARISA KAY (RN)
Entity type:Individual
Prefix:
First Name:LARISA
Middle Name:KAY
Last Name:ONG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43201 ROAD 762
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-3718
Mailing Address - Country:US
Mailing Address - Phone:308-325-5032
Mailing Address - Fax:
Practice Address - Street 1:300 E 12TH ST
Practice Address - Street 2:
Practice Address - City:COZAD
Practice Address - State:NE
Practice Address - Zip Code:69130-1532
Practice Address - Country:US
Practice Address - Phone:308-784-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE70592163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty