Individual
JASON M LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA, DNP
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-8237
(859) 323-5956
(859) 323-1080
Mailing address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4018931
KY
367500000X
Certified Registered Nurse Anesthetist
APN19921
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q016239
—
TN
Enumeration date
12/12/2013
Last updated
07/09/2024
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