Individual
KIRSTEN W LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3329 N RICHMOND STREET, APPLETON, WI 54911
(920) 380-2715
Mailing address
3329 N RICHMOND STREET, APPLETON, WI 54911
(920) 380-2715
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
41362-020
WI
207Q00000X
Family Medicine Physician
Primary
41362-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32643000
—
WI
Enumeration date
06/16/2006
Last updated
11/27/2012
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