Individual
ASHLEY J LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3635 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-5711
(228) 872-1951
(228) 875-9998
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 872-1951
(228) 875-9998
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA-519
AL
363AM0700X
Medical Physician Assistant
Primary
PA00156
MS
363AS0400X
Surgical Physician Assistant
200067
LA
363LC0200X
Critical Care Medicine Nurse Practitioner
PA00156
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06105593
—
MS
05
—
1371866
—
LA
01
—
302I970729
MEDICARE
MS
Enumeration date
10/17/2006
Last updated
04/16/2026
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