Individual
PAMELA KAY LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
106 4TH AVE. N., FERGUS FALLS, MN 56537
(218) 998-3778
(218) 998-3187
Mailing address
P.O. BOX 121, PEQUOT LAKES, MN 56472
(763) 443-1286
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L066017-8
MN
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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