Dreyer, Larissa Forde

Dreyer, Larissa Forde is an individual health care provider with primary practice located at 1 Medical Center Dr Dartmouth Hitchcock - Family Med, Lebanon NH 03756-1000. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Dreyer, Larissa Forde can be contacted via phone (603) 650-5922.

Contact Information

Primary practice address
1 Medical Center Dr Dartmouth Hitchcock - Family Med Lebanon NH 03756-1000
Phone: (603) 650-5922
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1076-39 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1166 New Hampshire

Profile Details

NPI number 1194045377
LBN Legal business name Dreyer, Larissa Forde
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2010
Last updated May 23rd, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1194045377 NPPES
Wisconsin Other 1076-39 WISCONSIN DEPARTMENT OF REGULATION & LICENSING

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