Individual
ANNALISE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17808 OLD EXCELSIOR BLVD, MINNETONKA, MN 55345-4242
(678) 509-6455
Mailing address
6332 RED CEDAR DR, CHASKA, MN 55318-5006
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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