Individual
MRS. MELANIE VANESSA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1055 WESTGATE DR STE 100, SAINT PAUL, MN 55114-1451
(612) 262-7800
Mailing address
1055 WESTGATE DR STE 100, SAINT PAUL, MN 55114-1451
(612) 262-7800
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R147972-4
MN
Other
Enumeration date
07/29/2010
Last updated
11/10/2020
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