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Individual

MS. PAULA LYNN LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
6120-B WOODLAND AVE, 2ND FLOOR, PHILADELPHIA, PA 19142
(215) 727-4721
Mailing address
4700 WISSAHICKON AVENUE, SUITE 118, PHILADELPHIA, PA 19144
(267) 597-3654
(267) 597-3622

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN349585L
PA
363L00000X
Nurse Practitioner
TP004902B
PA
363LC1500X
Community Health Nurse Practitioner
TP004902B
PA
363LF0000X
Family Nurse Practitioner
TP004902B
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
TP004902B
PA

Other

Enumeration date
08/04/2006
Last updated
06/29/2021
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