Individual
DIANE B LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1001 HART BLVD, STE 100, MONTICELLO, MN 55362-8670
(763) 295-2921
Mailing address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R1403473
MN
Other
Enumeration date
05/25/2007
Last updated
07/29/2016
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