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Individual

DR. JEANETTE PUESCHEL LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
0101270991
VA
2084N0400X
Neurology Physician
Primary
200701520
NC
2084N0400X
Neurology Physician
27215
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200701520
STATE LICENSE
NC
01
27215
STATE LICENSE
AZ
Enumeration date
03/15/2006
Last updated
04/08/2025
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