Larson, Mitchell D

Larson, Mitchell D is an individual health care provider with primary practice located at 1801 16Th St , Greeley CO 80631-5154. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Larson, Mitchell D can be contacted via phone (970) 352-4121.

Contact Information

Primary practice address
1801 16Th St Greeley CO 80631-5154
Phone: (970) 352-4121
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1378618 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRA-15015 Colorado

Profile Details

NPI number 1639147705
LBN Legal business name Larson, Mitchell D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jun 23rd, 2010 - about 16 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 1639147705 NPPES
Minnesota MEDICAID 122019500
Minnesota MEDICAID 16674847

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