Individual
HEIDI LEA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 255-2048
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R35159
ND
163WP2201X
Ambulatory Care Registered Nurse
Primary
R35159
ND
Other
Enumeration date
11/15/2024
Last updated
03/24/2026
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