Larson, Jennifer Ruth

Larson, Jennifer Ruth is an individual health care provider with primary practice located at 1515 Saint Francis Ave Suite 150, Shakopee MN 55379-3387. 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, Jennifer Ruth can be contacted via phone (952) 403-3399.

Contact Information

Primary practice address
1515 Saint Francis Ave Suite 150 Shakopee MN 55379-3387
Phone: (952) 403-3399
Fax: (952) 403-3390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9789 Minnesota

Profile Details

NPI number 1285684555
LBN Legal business name Larson, Jennifer Ruth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Nov 17th, 2022 - about 4 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 1285684555 NPPES
Minnesota MEDICAID 216702600

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