Individual
AMY F LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6300
(952) 967-7616
Mailing address
8170 33RD AVE, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
510
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135425600
—
MN
Enumeration date
03/08/2006
Last updated
05/26/2022
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