Larsen, Amy
Larsen, Amy is an individual health care provider with primary practice located at 640 Jackson St , Saint Paul MN 55101-2502. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Larsen, Amy can be contacted via phone (651) 254-3456.Contact Information
Primary practice address
640 Jackson St
Saint Paul MN 55101-2502
Phone: (651) 254-3456
Fax: (651) 254-9673
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 46577 | Minnesota |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 46577 | Minnesota |
Profile Details
| NPI number | 1720168537 |
|---|---|
| LBN Legal business name | Larsen, Amy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | Mar 17th, 2018 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720168537 | NPPES |
| Minnesota | Other | 2368958 | AMERICA'S PPO |
| Minnesota | Other | 505925 | AMERICA'S PPO |
| Minnesota | Other | 04-00123 | AMERICA'S PPO |
| Minnesota | MEDICAID | 34629900 | AMERICA'S PPO |
| Minnesota | MEDICAID | 0591149 | AMERICA'S PPO |
| Minnesota | Other | 1045965 | AMERICA'S PPO |
| Minnesota | Other | B539 | AMERICA'S PPO |
| Minnesota | Other | HP53301 | AMERICA'S PPO |
| Minnesota | Other | 0407540 | AMERICA'S PPO |
| Minnesota | Other | 132940 | AMERICA'S PPO |
| Minnesota | Other | 631T3LA | AMERICA'S PPO |
| Minnesota | MEDICAID | 622695700 | AMERICA'S PPO |
| Minnesota | Other | 9376963 | AMERICA'S PPO |
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