Individual
DR. JENNIFER ELLEN LARSON
Active
Individual
DR. JENNIFER ELLEN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006-00564
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00513
BCBS
NC
01
—
0081P
BCBS SWINGBED
NC
01
—
014MX
BCBS LABS
NC
01
—
07673
BCBS PHYSICIAN
NC
01
—
1479X
BCBS INDIVIDUAL PROVIDER
NC
01
—
2061740
MEDICARE PHYSICIAN
NC
01
—
235013
MEDICARE PHYSICIAN
NC
01
—
235013B
MEDICARE PHYSICIAN
NC
01
—
3400011
MEDICAID OSCAR
NC
01
—
34U011
MEDICARE SWINGBED
NC
05
—
5906586
—
NC
01
—
8907673
MEDICAID PHYSICIAN
NC
01
—
CA1796
RAILROAD MEDICARE
NC
Enumeration date
01/03/2007
Last updated
02/10/2015
Update your record
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