Larson, Jaimee M
Larson, Jaimee M is an individual health care provider with primary practice located at 704 S Webster Ave Ste 501 , Green Bay WI 54301-3528. 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, Jaimee M can be contacted via phone (920) 433-6050.Contact Information
Primary practice address
704 S Webster Ave Ste 501
Green Bay WI 54301-3528
Phone: (920) 433-6050
Fax: (920) 433-6049
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3545-23 | Wisconsin |
Profile Details
| NPI number | 1225419120 |
|---|---|
| LBN Legal business name | Larson, Jaimee M |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2015 |
| Last updated | Sep 22nd, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225419120 | NPPES |
| Other | 1116573 | NCCPA |
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