Larsen, Richard E

Larsen, Richard E is an individual health care provider with primary practice located at 5290 Mcnutt Road , Santa Teresa NM 88008-1590. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Larsen, Richard E can be contacted via phone (505) 589-1144.

Contact Information

Primary practice address
5290 Mcnutt Road Santa Teresa NM 88008-1590
Phone: (505) 589-1144
Fax: (505) 589-2008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X N99PA22 New Mexico

Profile Details

NPI number 1235182312
LBN Legal business name Larsen, Richard E
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235182312 NPPES
New Mexico Other 00120 BCBS OF NM

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