Individual
JULIE N. LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
N57W24950 N CORPORATE CIR, SUSSEX, WI 53089-4383
(262) 820-3093
Mailing address
N57W24950 N CORPORATE CIR, SUSSEX, WI 53089-4383
(262) 820-3093
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27016
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30668200
—
WI
Enumeration date
02/13/2006
Last updated
04/20/2012
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