Individual
BARBARA JEANNE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
116 COURT ST, PLYMOUTH, MA 02360-8710
(508) 747-1318
(508) 747-1410
Mailing address
116 COURT ST, PLYMOUTH, MA 02360-8710
(508) 747-1318
(508) 747-1410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA002657L
PA
363AM0700X
Medical Physician Assistant
MA002657L
PA
363AM0700X
Medical Physician Assistant
Primary
PA4622
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138350
HEALTHAMERICA
PA
01
—
242966YHMK
MEDICARE PTAN
PA
01
—
2517979
UNITEDHEALTHCARE
PA
Enumeration date
03/31/2006
Last updated
09/14/2020
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