Larson, Charles Blaise

Larson, Charles Blaise is an sole proprietor health care provider with primary practice located at 730 N College Rd Ste B , Twin Falls ID 83301-3382. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Larson, Charles Blaise can be contacted via phone (208) 814-7350.

Contact Information

Primary practice address
730 N College Rd Ste B Twin Falls ID 83301-3382
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP-1716A Idaho

Profile Details

NPI number 1497120349
LBN Legal business name Larson, Charles Blaise
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 3rd, 2015
Last updated May 9th, 2016 - about 9 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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