Individual
SARAH NICOLE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MS
Contact information
Practice address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 625-4031
Mailing address
MCHSMN ROVIDER ENROLLMENT 200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33568
MN
390200000X
Student in an Organized Health Care Education/Training Program
33568
MN
Other
Enumeration date
05/10/2022
Last updated
05/25/2023
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