Individual
CRYSTAL LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11204 86TH AVE N, MAPLE GROVE, MN 55369-4510
(612) 470-0105
(612) 299-1425
Mailing address
14111 93RD PL N, MAPLE GROVE, MN 55369-8912
(612) 670-2058
(612) 299-1425
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
414944
MN
374U00000X
Home Health Aide
414944
MN
376J00000X
Homemaker
414944
MN
376K00000X
Nurse's Aide
414944
MN
385H00000X
Respite Care
414944
—
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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