Larson, Brenda R

Larson, Brenda R is an individual health care provider with primary practice located at 3931 Louisiana Ave S , St Louis Park MN 55426-5000. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Larson, Brenda R can be contacted via phone (952) 993-3248.

Contact Information

Primary practice address
3931 Louisiana Ave S St Louis Park MN 55426-5000
Phone: (952) 993-3248
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 48944 Minnesota

Profile Details

NPI number 1952310237
LBN Legal business name Larson, Brenda R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Apr 13th, 2016 - about 8 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 1952310237 NPPES
Minnesota MEDICAID 652600000
Minnesota MEDICAID 35216700
Minnesota MEDICAID ENROLLED
Minnesota Other P00391392

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