Larson, Andrea

Larson, Andrea is an individual health care provider with primary practice located at 160 Allen St , Rutland VT 05701-4560. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Larson, Andrea can be contacted via phone (802) 775-7111.

Contact Information

Primary practice address
160 Allen St Rutland VT 05701-4560
Phone: (802) 775-7111
Fax: (802) 747-6260
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 055-0030490 Vermont

Profile Details

NPI number 1821158346
LBN Legal business name Larson, Andrea
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jul 8th, 2007 - about 18 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 1821158346 NPPES
Vermont MEDICAID OVN0503

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