Individual
LAURIE L LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
420 DELAWARE ST SE, MMC 36, MINNEAPOLIS, MN 55455-0001
(612) 273-8425
Mailing address
2992 VANDERBIE ST, LITTLE CANADA, MN 55117-1225
(651) 470-5276
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R1462760
MN
363LA2100X
Acute Care Nurse Practitioner
1249
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
10/09/2009
Last updated
12/01/2021
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