Larson, Jeannie Therese

Larson, Jeannie Therese is an individual health care provider with primary practice located at 9555 Upland Lane N , Maple Grove MN 55369. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is her primary health care specialty. Larson, Jeannie Therese can be contacted via phone (952) 993-3260.

Contact Information

Primary practice address
9555 Upland Lane N Maple Grove MN 55369
Phone: (952) 993-3260
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 33568 Minnesota
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 33568 Minnesota

Profile Details

NPI number 1164406369
LBN Legal business name Larson, Jeannie Therese
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Aug 14th, 2020 - about 6 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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